Work

Hypoalbuminemia (< 3.0 g/dl) and Poor Karnofsky Performance (KPS<80) at Day +90 Are Independent Predictors of Worse Non-Relapse Survival (NRS) and Overall Survival (OS) in Adult Allogeneic Hematopoietic Cell Transplantation (allo-HCT) Recipients: Results of a Multivariable Analysis

Year: 2009

Type: article

Abstract: Tabled 1Multivariable Regression Analysis for OS and NRS† Post-transplant variables at day 90 (±7) post-allo HCT §OSNRSHospital stay (≤5 vs. >5 days)∗from hematopoietic engraftment until day 90 (±7).NSNSDays of TPN (>0 vs. 0)∗NSNSPRBC transfusion (>0 vs. 0)∗from hematopoietic engraftment until day 90 (±7).NSNSPlatelets transfusion (>0 vs. 0)∗from hematopoietic engraftment until day 90 (±7).NSNSPneumonia episodes (>0 vs. 0)∗from hematopoietic engraftment until day 90 (±7)., ¥development of infiltrates requiring additional/alternative antimicrobials.NSp=0.0008; 2.8 (1.5, 5.1)Episodes of CMV reactivation (>0 vs. 0)∗from hematopoietic engraftment until day 90 (±7).NSNSCumulative dose of steroids (<2,650mg vs. ≥ 2,650mg)∗from hematopoietic engraftment until day 90 (±7).NSp=0.001; 0.4 (0.2, 0.7)Total days of steroids (<60 vs. ≥60)∗from hematopoietic engraftment until day 90 (±7).NSNSDose of steroid at day 90 (±7) (<20 vs. ≥20mg/day)NSNS% weight loss (≤10% vs. >10%)from initiation of conditioning chemotherapy (baseline) until day 90 (±7).NSNSAcute GVHD (max grade) 0-I vs. II vs. III-IVNSNSKPS at day 90 (±7) (<80 vs. ≥80)p<0.0001; 4.7 (3.0, 7.4)p<0.0001; 3.9 (2.0, 7.5)Total bilirubin at day 90 (±7) (<1.1 vs. ≥1.1mg/dl)NSNS% Creatinine change (≥30 vs. <30)∗from hematopoietic engraftment until day 90 (±7).p=0.0002; 2.2 (1.5, 3.3)NSAlbumin at day 90 (±7) < 3.0 g/dl vs. > 3.5 g/dl; 3.0-3.5 g/dl vs. > 3.5 g/dlp=0.006; 2.5 (1.4, 4.5); 1.5 (0.9, 2.3)p=0.01; 3.2 (1.4, 7.1); 1.2 (0.6, 2.3)Additional immunosuppressive therapy (ies) (>0 vs. 0)^additional anti-GVHD therapy(ies) apart from standard GVHD prophylaxis and glucocorticoids until day 90 (±7).NSNSAdditional anti-microbial(s) (>0 vs. 0)additional antimicrobials apart from acyclovir, fluconazole or voriconazole (whenever used for primary prohylaxis) and trimethoprin-sulfamethoxazole (or equivalents).p=0.002; 2.8 (1.5, 5.3)NS†Table entry: p-value (p) for the covariate effect;Hazard ratio (HR) (95% CI).§The effects of post-transplant variables were adjusted for baseline variables such as age, KPS and patient/donor CMV statuses in this regression, whenever appropriate/necessary. Statistical significance defined as <0.05; NS: not significant (p≥0.05). TPN: total parenteral nutrition.∗ from hematopoietic engraftment until day 90 (±7).∗∗ from initiation of conditioning chemotherapy (baseline) until day 90 (±7).^ additional anti-GVHD therapy(ies) apart from standard GVHD prophylaxis and glucocorticoids until day 90 (±7).^^ additional antimicrobials apart from acyclovir, fluconazole or voriconazole (whenever used for primary prohylaxis) and trimethoprin-sulfamethoxazole (or equivalents).¥ development of infiltrates requiring additional/alternative antimicrobials. Open table in a new tab †Table entry: p-value (p) for the covariate effect;Hazard ratio (HR) (95% CI). §The effects of post-transplant variables were adjusted for baseline variables such as age, KPS and patient/donor CMV statuses in this regression, whenever appropriate/necessary. Statistical significance defined as <0.05; NS: not significant (p≥0.05). TPN: total parenteral nutrition.

Source: Transplantation and Cellular Therapy

DOI: 10.1016/j.bbmt.2008.12.018