Risk Factors for Rehospitalizations after Allogeneic Hematopoietic Stem Cell Transplantation

AUTOIMMUNE THROMBOCYTOPENIA

MYu Drokov, AA Dmitrova, LA Kuzmina, VA Vasil’eva, ED Mikhaltsova, OM Koroleva, EV Usikova, EN Parovichnikova, VG Savchenko

National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Mikhail Yur’evich Drokov, MD, PhD, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: +7(495)614-90-42; e-mail: mdrokov@gmail.com

For citation: Drokov MYu, Dmitrova AA, Kuzmina LA, et al. Risk Factors for Rehospitalization after Allogeneic Hematopoietic Stem Cell Transplantation. Clinical oncohematology. 2020;13(1):89–94 (In Russ).

DOI: 10.21320/2500-2139-2020-13-1-89-94

ABSTRACT

Aim. To assess the rehospitalization data of patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT), to determine possible risk factors for rehospitalization, and to work out a strategy of post-transplantation follow-up for this category of patients.

Materials & Methods. From 2009 to 2019 at the National Research Center for Hematology 418 patients received allo-HSCT. The final analysis included 374 patients who were discharged from hospital after allo-HSCT. The reasons for rehospitalizations of patients with allo-HSCT within 30 days after their hospital discharge were subjected to analysis. Independent risk factors for rehospitalizations were identified by the Cox model. Risk density was visually estimated within 365 days after hospital discharge with the purpose of working out the optimal strategy of post-transplantation follow-up for this category of patients.

Results. The probability of rehospitalization within 30 days after hospital discharge was 30.7 % for all patients with allo-HSCT. The data assessment showed that the majority of rehospitalizations (55.7 %) were associated with infectious complications. Acute graft-versus-host disease (GVHD) during the first hospitalization, i.e. immediately after allo-HSCT during the hospital stay, proved to enhance the probability of rehospitalizations within 30 days after hospital discharge by 1.7 times compared with the patients without acute GVHD.

Conclusion. The leading cause of rehospitalizations of patients with allo-HSCT within 30 days after hospital discharge was acute GVHD which occurred before, i.e. during the first hospital stay. The data obtained demonstrate the necessity of close monitoring of a patient’s status within the first 120 days after discharge from the hospital where allo-HSCT was performed.

Keywords: allogeneic hematopoietic stem cell transplantation, rehospitalizations, graft-versus-host disease.

Received: July 16, 2019

Accepted: December 17, 2019

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