Wu Peihua, Huo Wenxuan, Zhao Huiying, Lv Jie, Lv Shan, An Youzhong
Department of Critical Care Medicine, Peking University People's Hospital, Beijing 100044, P.R. China.
Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Beijing 100044, P.R. China.
Exp Ther Med. 2024 Feb 27;27(4):168. doi: 10.3892/etm.2024.12457. eCollection 2024 Apr.
Hematological malignant tumors represent a group of major diseases carrying a substantial risk to the lives of affected patients. Risk factors for mortality in critically ill patients have garnered substantial attention in recent research endeavors. The present research aimed to identify factors predicting intensive care unit (ICU) mortality in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Furthermore, the present study analyzed and compared the mortality rate between patients undergoing haploidentical hematopoietic stem cell transplantation (Haplo-SCT) and those undergoing identical sibling donor (ISD) transplantation. A total of 108 patients were included in the present research, 83 (76.9%) of whom underwent Haplo-SCT. ICU mortality was reported in 58 (53.7%) patients, with the values of 55.4 and 48.0% associated with Haplo-SCT and ISD, respectively (P=0.514). The mortality rate of patients undergoing Haplo-SCT was comparable to that of patients undergoing ISD transplantation. The present study found that reduced hemoglobin, elevated total bilirubin, elevated brain natriuretic peptide, elevated fibrinogen degradation products, need for vasoactive drugs at ICU admission, need for invasive mechanical ventilation and elevated APACHE II scores were independent risk factors for ICU mortality. Among patients presenting with 5-7 risk factors, the ICU mortality reached 100%, significantly exceeding that of other patients. The present research revealed that ICU mortality rates remain elevated among patients who underwent allo-HSCT, especially those presenting multiple risk factors. However, the outcome of patients undergoing Haplo-SCT were comparable to those of patients undergoing ISD transplants.
血液系统恶性肿瘤是一组对患者生命构成重大风险的主要疾病。危重症患者的死亡风险因素在最近的研究中受到了广泛关注。本研究旨在确定异基因造血干细胞移植（allo-HSCT）患者重症监护病房（ICU）死亡率的预测因素。此外，本研究分析并比较了单倍体造血干细胞移植（Haplo-SCT）患者和同基因同胞供者（ISD）移植患者的死亡率。本研究共纳入108例患者，其中83例（76.9%）接受了Haplo-SCT。58例（53.7%）患者报告了ICU死亡率，Haplo-SCT组和ISD组的死亡率分别为55.4%和48.0%（P=0.514）。接受Haplo-SCT患者的死亡率与接受ISD移植患者的死亡率相当。本研究发现，血红蛋白降低、总胆红素升高、脑钠肽升高、纤维蛋白原降解产物升高、ICU入院时需要血管活性药物、需要有创机械通气以及APACHE II评分升高是ICU死亡率的独立危险因素。在存在5-7个危险因素的患者中，ICU死亡率达到100%，显著高于其他患者。本研究表明，接受allo-HSCT的患者，尤其是存在多个危险因素的患者，ICU死亡率仍然较高。然而，接受Haplo-SCT患者的结局与接受ISD移植患者的结局相当。
