Early predictors of mortality in children with pulmonary complications after haematopoietic stem cell transplantation.

Abstract

PC are a main cause of death following HSCT in children. We aimed to evaluate early predictors of mortality in paediatric recipients with PCs. A retrospective observational study of 35 patients with 49 episodes of PI on chest radiography (of 124 patients) who had undergone HSCT at a tertiary university hospital between January 2011 and December 2012 was performed. During follow-up (median 26.1 months), 15 episodes led to death (30.6%). An aetiologic diagnosis was made by non-invasive tests in 24 episodes (49.0%) and by adding bronchoalveolar lavage and/or lung biopsy in 7 episodes with diagnostic yield (77.8%, P = .001). Thus, a specific diagnosis was obtained in 63.3% of the episodes. Aetiology identification and treatment modification after diagnosis did not decrease mortality (P = .057, P = .481). However, the number of organ dysfunctions at the beginning of PI was higher in the mortality group, compared to the survivor group (1.7 ± 1.2 vs 0.32 ± 0.59; P = .001). Hepatic dysfunction (OR, 11.145; 95% CI, 1.23 to 101.29; P = .032) and neutropaenia (OR, 10.558; 95% CI, 1.07 to 104.65; P = .044) were independently associated with risk of mortality. Therefore, hepatic dysfunction and neutropaenia are independent early predictors of mortality in HSCT recipients with PCs.

DOI: 10.1111/petr.13062

Cite this paper

@article{Choi2017EarlyPO, title={Early predictors of mortality in children with pulmonary complications after haematopoietic stem cell transplantation.}, author={Yu Hyeon Choi and Hyung Joo Jeong and Hong Yul An and You Sun Kim and Eui Jun Lee and Bongjin Lee and Hyoung Jin Kang and Hee Young Shin and June Dong Park}, journal={Pediatric transplantation}, year={2017} }