Early transplantation-related mortality after allogeneic hematopoietic cell transplantation in patients with acute leukemia

BackgroundTransplantation-related mortality (TRM) is a major obstacle in allogeneic hematopoietic cell transplantation (allo-HCT). Approximately 60-80% of TRM occurs early, within 100days of transplantation.MethodsThis was a nationwide population cohort study involving 5395 patients with acute leukemia who underwent allo-HCT between 2003 and 2015. Patient data were collected from the Korean National Health Insurance Service database. We investigated the cumulative incidence rates (CIRs) of early TRM at 50 and 100days.ResultsThe CIRs of early TRM at 50 and 100days were 2.9 and 8.3%, respectively. There was no decrease in the CIRs of early TRM over time. The early mortality was significantly higher in patients with more than 9months between the diagnosis and transplantation (CIRs of TRM at 50, 100days; 6.0, 13.2%), previous transplantations (CIRs of TRM at 50, 100days; 9.4, 17.2%), and cord blood transplantation (CIRs of TRM at 50, 100days; 6.1, 8.3%). The early TRM was significantly lower in patients who received iron chelation before transplantation (CIRs of TRM at 50, 100days; 0.3, 1.8%).ConclusionsIn conclusion, the overall CIR of early TRM was less than 10%. The predictable factors for early TRM included age, time from diagnosis to transplantation, the number of prior transplantations, the graft source, and previous iron chelation therapy.

Automated summary

The study revealed that the cumulative incidence rates of early TRM at 50 and 100 days were 2.9% and 8.3% respectively. Predictable factors for early TRM included age, time from diagnosis to transplantation, number of prior transplantations, graft source, and previous iron chelation therapy.