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. 2021 Feb 18;21(1):177.
doi: 10.1186/s12885-021-07897-3.

Early transplantation-related mortality after allogeneic hematopoietic cell transplantation in patients with acute leukemia

Seom Gim Kong  1 , Seri Jeong  2 , Sangjin Lee  3 , Jee-Yeong Jeong  4   5 , Da Jung Kim  6 , Ho Sup Lee  7
Affiliations

Early transplantation-related mortality after allogeneic hematopoietic cell transplantation in patients with acute leukemia

Seom Gim Kong et al. BMC Cancer. .

Abstract

Background: Transplantation-related mortality (TRM) is a major obstacle in allogeneic hematopoietic cell transplantation (allo-HCT). Approximately 60-80% of TRM occurs early, within 100 days of transplantation.

Methods: This was a nationwide population cohort study involving 5395 patients with acute leukemia who underwent allo-HCT between 2003 and 2015. Patient data were collected from the Korean National Health Insurance Service database. We investigated the cumulative incidence rates (CIRs) of early TRM at 50 and 100 days.

Results: The CIRs of early TRM at 50 and 100 days were 2.9 and 8.3%, respectively. There was no decrease in the CIRs of early TRM over time. The early mortality was significantly higher in patients with more than 9 months between the diagnosis and transplantation (CIRs of TRM at 50, 100 days; 6.0, 13.2%), previous transplantations (CIRs of TRM at 50, 100 days; 9.4, 17.2%), and cord blood transplantation (CIRs of TRM at 50, 100 days; 6.1, 8.3%). The early TRM was significantly lower in patients who received iron chelation before transplantation (CIRs of TRM at 50, 100 days; 0.3, 1.8%).

Conclusions: In conclusion, the overall CIR of early TRM was less than 10%. The predictable factors for early TRM included age, time from diagnosis to transplantation, the number of prior transplantations, the graft source, and previous iron chelation therapy.

Keywords: Acute leukemia; Cumulative incidence rates; Hematopoietic stem cell transplantation; Risk factor; Transplantation-related mortality.

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Conflict of interest statement

There are no potential competing interests relevant to this article to report.

Financial disclosure statements: All authors have nothing to declare.

Figures

Fig. 1
Fig. 1
Cumulative incidence rates (CIRs) of early transplant-related mortality after HCT. a CIRs of early mortality at 50 and 100 days after transplantation in patients with acute leukemia were 2.9 and 8.3%, respectively. b In children and adults, the CIRs of early mortality at 50 days were 1.9 and 3.2% (p = 0.044), and the CIRs of early mortality at 100 days were 6.6 and 8.7% (p = 0.024), respectively
Fig. 2
Fig. 2
The comparison of cumulative incidence rates of early transplant-related mortality according to the variables. a age, (b) time from diagnosis to transplantation, (c) previous number of transplantations, (d) previous therapy with iron chelation, and (e) graft sources
See this image and copyright information in PMC

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