Associations between febrile neutropenia-related parameters and the risk of acute GVHD or non-relapse mortality after allogeneic hematopoietic stem cell transplantation.
Acute Disease
Adolescent
Adult
Age Factors
Aged
Allografts
C-Reactive Protein
/ metabolism
Disease-Free Survival
Febrile Neutropenia
/ blood
Female
Graft vs Host Disease
/ blood
Hematopoietic Stem Cell Transplantation
Humans
Infections
/ blood
Male
Middle Aged
Retrospective Studies
Risk Factors
Survival Rate
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
12
06
2018
accepted:
15
08
2018
revised:
03
08
2018
pubmed:
2
9
2018
medline:
2
7
2020
entrez:
2
9
2018
Statut:
ppublish
Résumé
Infection and inflammation can induce acute graft-vs.-host disease (aGVHD). We hypothesized that febrile neutropenia early after allogeneic hematopoietic cell transplantation (HCT) would increase the risk of aGVHD and non-relapse mortality (NRM). We retrospectively evaluated the impact of fever, C-reactive protein (CRP) concentration and blood stream infection (BSI) early after HCT on the incidence of grade II-IV aGVHD and NRM in 227 patients. Within 7 days after HCT, 91 (40.1%) patients experienced fever for at least 2 days (early-FN group). BSI occurred in 27 (11.9%) patients and the maximum CRP concentration was 2.57 mg/dl in the median. In a multivariate analysis, early-FN (hazard ratio (HR) 1.81, P = 0.007) and older recipient age (HR 1.68, P = 0.019) were significantly associated with the incidence of grade II-IV aGVHD. High-CRP and BSI were not significant risk factors for grade II-IV aGVHD. On the other hand, high-CRP was significantly associated with the incidence of NRM (HR 2.67, P = 0.004) in a multivariate analysis. In conclusion, although fever, CRP elevation and BSI are considered to be closely related events, they had different effects on the incidence of aGVHD and NRM. The development of early-FN after HCT may predict the risk of aGVHD.
Identifiants
pubmed: 30171223
doi: 10.1038/s41409-018-0330-2
pii: 10.1038/s41409-018-0330-2
doi:
Substances chimiques
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
707-716Références
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