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Early treatment-related mortality in adult autologous stem cell transplant recipients: a nation-wide survey of 1482 transplanted patients

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Jantunen E, Itälä M, Lehtinen T, Kuittinen O, Koivunen E, Leppä S, Juvonen E, Koistinen P, Wiklund T, Nousiainen T, Remes K, Volin L. Early treatment-related mortality in adult autologous stem cell transplant recipients: a nation-wide survey of 1482 transplanted patients.

Eur J Haematol 2006. © Blackwell Munksgaard 2006. Abstract: 

Objectives: To evaluate early (<100 d) treatment-related mortality (TRM) in autologous stem cell transplant (ASCT) recipients. Patients: Altogether 1482 adult patients received ASCT in six Finnish centres 1990–2003. The most common diagnoses were non-Hodgkin's lymphoma (NHL) (n = 542), multiple myeloma (MM) (n = 528), breast cancer (BC) (n = 132), Hodgkin's lymphoma (n = 86) and chronic lymphocytic leukaemia (CLL) (n = 63). Results: Forty-two patients (2.8%) died from treatment-related reasons <100 d from ASCT. The median time to death was 38 d from ASCT (0–99). The risk of TRM varied according to the diagnoses. The highest risk was observed in patients with AL amyloidosis (24%) followed by NHL (4.4%) and MM (1.9%). No early TRM was observed in patients transplanted for BC or CLL. Infections were the cause of death in 16 patients (fungal 7, bacterial 6, viral 3). Organ toxicity was responsible for early death in 26 patients (heart 9, lungs 7, other 10). Conclusions: This nation-wide survey indicated a low early TRM in ASCT recipients in general, but higher risks in patients with AL amyloidosis or NHL. In addition to patient selection, also optimization of transplant procedure may be needed in these patient groups to reduce early TRM.
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Keywords: autologous stem cell transplantation; early; infections; organ toxicity; treatment-related mortality

Document Type: Research Article

Affiliations: 1: Department of Medicine, Kuopio University Hospital, Kuopio, Finland 2: Department of Medicine, Turku University Central Hospital, Turku, Finland 3: Department of Oncology, Tampere University Hospital, Tampere, Finland 4: Department of Oncology, Oulu University Hospital, Oulu, Finland 5: Department of Medicine, Tampere University Hospital, Tampere, Finland 6: Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland 7: Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland 8: Department of Medicine, Oulu University Hospital, Oulu, Finland

Publication date: March 1, 2006

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