Organ Failure Following Allogeneic Hematopoietic Stem Cell Transplantation and Transplant Outcome Organ Failure
-
Elham Roshandel
,
Mohsen Hamidpour
,
Haniyeh Ghaffari Nazari
,
Shayan Zamani
,
Mohammad Hassani
,
Anahita Saeedi
,
Abbas Hajifathali
Abstract
Organ failure, including; liver toxicity, renal failure, and neurotoxicity, are frequent complications following HSCT which can affect the transplant outcome, morbidity, and mortality of allo-HSCT recipients: A retrospective study of 206 allo-HSCT patients was conducted to determine the frequency of organ failure and overall survival in patients receiving allo-HSCT. Liver toxicity, renal failure, and neurotoxicity were diagnosed according to clinical and laboratory records pre and post-allo-HSCT. A total of 33 patients (16%) developed organ failure within 200 days after allo-HSCT. Liver toxicity was diagnosed in 12% of patients, and the median time of its occurrence was 22 days (range: 0-207 days) post-allo-HSCT. Two percent (6 of 206) of allo-HSCT recipients presented renal failure. Renal failure was developed within the median time of 33 days (range: 5-88 days). Neurological involvement occurred in 0.9% of patients. Among 206 patients, the frequency of complications such as veno-occlusive disease (VOD) and graft-versus-host disease (GVHD) was 1.4% and 16.01%, respectively. One-year overall survival of patients who had organ failure was 24%, and the mean survival determined 329±99.58 days. Three-month overall survival of patients who developed liver injury and renal failure were 78% and 33%, respectively. Organ failure remains a common complication in patients who received allo-HSCT. Patients with GVHD and two or multi-organ involvement seem to have lower overall survival.
1. Sureda A, Bader P, Cesaro S, Dreger P, Duarte RF, Dufour C, et al. Indications for allo-and auto-SCT for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2015 Mar 23 Bone Marrow Transplant 2015;50:1037-56.
2. Passweg JR, Baldomero H, Basak GW, Chabannon C, Corbacioglu S, Duarte R, et al. The EBMT activity survey report 2017: a focus on allogeneic HCT for nonmalignant indications and on the use of non-HCT cell therapies. Bone Marrow Transplant 2019;1:1575-85.
3. Copelan EA. Hematopoietic stem-cell transplantation. N Engl J Med 2006;354:1813-26.
4. Inamoto Y, Lee SJ. Late effects of blood and marrow transplantation. Haematologica 2017;102:614-25.
5. Majhail NS. Long-term complications after hematopoietic cell transplantation. Hematol Oncol Stem Cell Rher 2017;10:220-7.
6. Nassiri N, Eslani M, Panahi N, Mehravaran S, Ziaei A, Djalilian AR. Ocular graft versus host disease following allogeneic stem cell transplantation: a review of current knowledge and recommendations. J Ophthalmic Vis Res 2013;8:351-8.
7. Mourad N, Michel RP, Marcus VA. Pathology of Gastrointestinal and Liver Complications of Hematopoietic Stem Cell Transplantation. Arch Pathol Lab Med 2019;143:1131-43.
8. Sanders JE, Hoffmeister PA, Woolfrey AE, Carpenter PA, Storer BE, Storb RF, et al. Thyroid function following hematopoietic cell transplantation in children: 30 years’ experience. Blood 2009;113:306-8.
9. Kersting S, Dorp S V, Theobald M, Verdonck LF. Acute renal failure after nonmyeloablative stem cell transplantation in adults. Biol Blood Marrow Transplant 2008;14:125-31.
10. Peres E, Levine JE, Khaled YA, Ibrahim RB, Braun TM, Krijanovski OI, et al. Cardiac complications in patients undergoing a reduced-intensity conditioning hematopoietic stem cell transplantation. Bone Marrow Transplant 2010;45:149-52.
11. Lee MY, Chiou TJ, Yang MH, Bai LY, Hsiao LT, Chao TC, et al. Relatively favorable outcomes of post‐transplant pulmonary function in patients with chronic myeloid leukemia receiving non‐myeloablative allogeneic hematopoietic stem cell transplantation. Eur J Haematol 2005;74:152-7.
12. Dowling MR, Li S, Dey BR, McAfee SL, Hock HR, Spitzer TR, et al. Neurologic complications after allogeneic hematopoietic stem cell transplantation: risk factors and impact. Bone Marrow Transpl 2018;53:199-206.
13. Azar N, Valla D, Abdel-Samad I, Hoang C, Fretz C, Sutton L, et al. Liver dysfunction in allogeneic bone marrow transplantation recipients: Influence of pre-and posttransplantation hepatic lesions. Transplantation 1996;62:56-61.
14. Locasciulli A, Alberti A, De Bock R, Cordonnier C, Einsele H, Engelhard D, et al. Impact of liver disease and hepatitis infections on allogeneic bone marrow transplantation in Europe: a survey from the European Bone Marrow Transplantation (EBMT) Group--Infectious Diseases Working Party. Bone Marrow Transplant 1994;14:833-7.
15. McDonald GB. Hepatobiliary complications of hematopoietic cell transplant, 40 years on. Hepatology 2010;51:1450-60.
16. Coppell JA, Richardson PG, Soiffer R, Martin PL, Kernan NA, Chen A. Hepatic Veno-Occlusive Disease Following Stem Cell Transplantation: Incidence, Clinical Course, and Outcome. Biol Blood Marrow Transplant 2010;16:157-68.
17. Parikh CR, Coca SG. Acute renal failure in hematopoietic cell transplantation. Kidney Int 2006;69:430-5.
18. Lopes JA, Jorge S, Neves M. Acute kidney injury in HCT: an update. Bone Marrow Transplant 2016;51:755-62.
19. Liu H, Li YF, Liu BC, Ding JH, Chen BA, Xu WL, et al. A multicenter, retrospective study of acute kidney injury in adult patients with nonmyeloablative hematopoietic SCT. Bone Marrow Transplant 2010;45:153-8.
20. Kersting S, Koomans HA, Hene RJ, Verdonck LF. Acute renal failure after allogeneic myeloablative stem cell transplantation: retrospective analysis of incidence, risk factors and survival. Bone Marrow Transplant 2007;39:359-65.
21. Maffini E, Festuccia M, Brunello L, Boccadoro M, Giaccone L, Bruno B. Neurologic Complications after Allogeneic Hematopoietic StemCell Transplantation. Biol Blood Marrow Transplant 2017;23:388-97.
22. Siegal D, Keller A, Xu W, Bhuta S, Kim DH, Kuruvilla J, et al. Central nervous system complications after allogeneic hematopoietic stem cell transplantation: incidence, manifestations, and clinical significance. Biol Blood Marrow Transplant 2007;13:1369-79.
23. Sung AD, Chao NJ. Concise review: acute graft‐versus‐host disease: immunobiology, prevention, and treatment. Stem Cells Translat Med 2013;2:25-32.
24. Giboney PT. Mildly elevated liver transaminase levels in the asymptomatic patient. Am Fam Physician 2005;71:1105-10.
25. Kim BK, Chung KW, Sun HS, Suh JG, Min WS, Kang CS, et al. Liver disease during the first post-transplant year in bone marrow transplantation recipients: retrospective study. Bone Marrow Transplan 2000;26:193-7.
26. Jordan K, Pontoppidan P, Uhlving HH, Kielsen K, Burrin DG, Weischendorff S, et al. Gastrointestinal toxicity, systemic inflammation, and liver biochemistry in allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2017;23:1170-6.
27. Hogan WJ, Maris M, Storer B, Sandmaier BM, Maloney DG, Schoch HG, et al. Hepatic injury after nonmyeloablative conditioning followed by allogeneic hematopoietic cell transplantation: a study of 193 patients. Blood 2004;103:78-84.
28. Barba P, Martino R, Perez-Simon JA, Fernandez-Aviles F, Pinana JL, Valcárcel D, et al. Incidence, characteristics and risk factors of marked hyperbilirubinemia after allogeneic hematopoietic cell transplantation with reduced-intensity conditioning. Bone Marrow Transplant 2012;47:1343-9.
29. Maradei SC, Maiolino A, de Azevedo AM, Colares M, Bouzas LF, Nucci M. Serum ferritin as risk factor for sinusoidal obstruction syndrome of the liver in patients undergoing hematopoietic stem cell transplantation. Blood 2009;114:1270-5.
30. Lee SH, Yoo KH, Sung KW, Koo HH, Kwon YJ, Kwon MM, et al. Hepatic veno-occlusive disease in children after hematopoietic stem cell transplantation: incidence, risk factors, and outcome. Bone Marrow Transplant 2010;45:1287-93.
31. Mori J, Ohashi K, Yamaguchi T, Ando M, Hirashima Y, Kobayashi T, et al. Risk assessment for acute kidney injury after allogeneic hematopoietic stem cell transplantation based on Acute Kidney Injury Network criteria. Intern Med 2012;51:2105-10.
32. Kagoya Y, Kataoka K, Nannya Y, Kurokawa M. Pretransplant predictors and posttransplant sequels of acute kidney injury after allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2011;17:394-400.
33. Sadadi F, Najafi I, Hakemi M, Falaknazi K, Atari F, Bahar B. Frequency, risk factors, and outcome of acute kidney injury following bone marrow transplantation at Dr Shariati Hospital in Tehran. Iran J Kidney Dis 2010;4:20-6.
34. Hingorani SR, Guthrie K, Batchelder AM, Schoch G, Aboulhosn N, Manchion J, Mcdonald GB. Acute renal failure after myeloablative hematopoietic cell transplant: incidence and risk factors. Kidney Int 2005;67:272-7.
35. Schrier RW, Parikh CR. Comparison of renal injury in myeloablative autologous, myeloablative allogeneic and non-myeloablative allogeneic haematopoietic cell transplantation. Nephrol Dial Transplant 2005;20:678-83.
36. Caliskan Y, Besisik SK, Sargin D, Ecder T. Early renal injury after myeloablative allogeneic and autologous hematopoietic cell transplantation. Bone Marrow Transplant 2006;38:141-7.
37. Tokgoz B, Kocyigit I, Polat G, Eser B, Unal A, Kaynar L, et al. Acute renal failure after myeloablative allogeneic hematopoietic stem cell transplantation: incidence, risk factors, and relationship with the quantity of transplanted cells. Ren Fail 2010;32:547-54.
38. Parikh CR, McSweeney PA, Korular D, Ecder T, Merouani A, Taylor J, et al. Renal dysfunction in allogeneic hematopoietic cell transplantation. Kid int 2002;62:566-73.
39. Kishi Y, Miyakoshi S, Kami M, Ikeda M, Katayama Y, Murashige N,et al. Early central nervous system complications after reduced-intensity stem cell transplantation. Biol Blood Marrow Transplant 2004;10:561-8.
40. Barba P, Piñana JL, Valcárcel D, Querol L, Martino R, Sureda A, et al. Early and late neurological complications after reduced-intensity conditioning allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2009;15:1439-46.
41. Carreras E, Díaz-Beyá M, Rosiñol L, Martínez C, Fernández-Avilés F, Rovira M. The incidence of veno-occlusive disease following allogeneic hematopoietic stem cell transplantation has diminished and the outcome improved over the last decade. Biol Blood Marrow Transplant 2011;17:1713-20.
42. Zhang L, Chu J, Yu J, Wei W. Cellular and molecular mechanisms in graft‐versus‐host disease. J Leukoc Biol 2016;99:279-87.
2. Passweg JR, Baldomero H, Basak GW, Chabannon C, Corbacioglu S, Duarte R, et al. The EBMT activity survey report 2017: a focus on allogeneic HCT for nonmalignant indications and on the use of non-HCT cell therapies. Bone Marrow Transplant 2019;1:1575-85.
3. Copelan EA. Hematopoietic stem-cell transplantation. N Engl J Med 2006;354:1813-26.
4. Inamoto Y, Lee SJ. Late effects of blood and marrow transplantation. Haematologica 2017;102:614-25.
5. Majhail NS. Long-term complications after hematopoietic cell transplantation. Hematol Oncol Stem Cell Rher 2017;10:220-7.
6. Nassiri N, Eslani M, Panahi N, Mehravaran S, Ziaei A, Djalilian AR. Ocular graft versus host disease following allogeneic stem cell transplantation: a review of current knowledge and recommendations. J Ophthalmic Vis Res 2013;8:351-8.
7. Mourad N, Michel RP, Marcus VA. Pathology of Gastrointestinal and Liver Complications of Hematopoietic Stem Cell Transplantation. Arch Pathol Lab Med 2019;143:1131-43.
8. Sanders JE, Hoffmeister PA, Woolfrey AE, Carpenter PA, Storer BE, Storb RF, et al. Thyroid function following hematopoietic cell transplantation in children: 30 years’ experience. Blood 2009;113:306-8.
9. Kersting S, Dorp S V, Theobald M, Verdonck LF. Acute renal failure after nonmyeloablative stem cell transplantation in adults. Biol Blood Marrow Transplant 2008;14:125-31.
10. Peres E, Levine JE, Khaled YA, Ibrahim RB, Braun TM, Krijanovski OI, et al. Cardiac complications in patients undergoing a reduced-intensity conditioning hematopoietic stem cell transplantation. Bone Marrow Transplant 2010;45:149-52.
11. Lee MY, Chiou TJ, Yang MH, Bai LY, Hsiao LT, Chao TC, et al. Relatively favorable outcomes of post‐transplant pulmonary function in patients with chronic myeloid leukemia receiving non‐myeloablative allogeneic hematopoietic stem cell transplantation. Eur J Haematol 2005;74:152-7.
12. Dowling MR, Li S, Dey BR, McAfee SL, Hock HR, Spitzer TR, et al. Neurologic complications after allogeneic hematopoietic stem cell transplantation: risk factors and impact. Bone Marrow Transpl 2018;53:199-206.
13. Azar N, Valla D, Abdel-Samad I, Hoang C, Fretz C, Sutton L, et al. Liver dysfunction in allogeneic bone marrow transplantation recipients: Influence of pre-and posttransplantation hepatic lesions. Transplantation 1996;62:56-61.
14. Locasciulli A, Alberti A, De Bock R, Cordonnier C, Einsele H, Engelhard D, et al. Impact of liver disease and hepatitis infections on allogeneic bone marrow transplantation in Europe: a survey from the European Bone Marrow Transplantation (EBMT) Group--Infectious Diseases Working Party. Bone Marrow Transplant 1994;14:833-7.
15. McDonald GB. Hepatobiliary complications of hematopoietic cell transplant, 40 years on. Hepatology 2010;51:1450-60.
16. Coppell JA, Richardson PG, Soiffer R, Martin PL, Kernan NA, Chen A. Hepatic Veno-Occlusive Disease Following Stem Cell Transplantation: Incidence, Clinical Course, and Outcome. Biol Blood Marrow Transplant 2010;16:157-68.
17. Parikh CR, Coca SG. Acute renal failure in hematopoietic cell transplantation. Kidney Int 2006;69:430-5.
18. Lopes JA, Jorge S, Neves M. Acute kidney injury in HCT: an update. Bone Marrow Transplant 2016;51:755-62.
19. Liu H, Li YF, Liu BC, Ding JH, Chen BA, Xu WL, et al. A multicenter, retrospective study of acute kidney injury in adult patients with nonmyeloablative hematopoietic SCT. Bone Marrow Transplant 2010;45:153-8.
20. Kersting S, Koomans HA, Hene RJ, Verdonck LF. Acute renal failure after allogeneic myeloablative stem cell transplantation: retrospective analysis of incidence, risk factors and survival. Bone Marrow Transplant 2007;39:359-65.
21. Maffini E, Festuccia M, Brunello L, Boccadoro M, Giaccone L, Bruno B. Neurologic Complications after Allogeneic Hematopoietic StemCell Transplantation. Biol Blood Marrow Transplant 2017;23:388-97.
22. Siegal D, Keller A, Xu W, Bhuta S, Kim DH, Kuruvilla J, et al. Central nervous system complications after allogeneic hematopoietic stem cell transplantation: incidence, manifestations, and clinical significance. Biol Blood Marrow Transplant 2007;13:1369-79.
23. Sung AD, Chao NJ. Concise review: acute graft‐versus‐host disease: immunobiology, prevention, and treatment. Stem Cells Translat Med 2013;2:25-32.
24. Giboney PT. Mildly elevated liver transaminase levels in the asymptomatic patient. Am Fam Physician 2005;71:1105-10.
25. Kim BK, Chung KW, Sun HS, Suh JG, Min WS, Kang CS, et al. Liver disease during the first post-transplant year in bone marrow transplantation recipients: retrospective study. Bone Marrow Transplan 2000;26:193-7.
26. Jordan K, Pontoppidan P, Uhlving HH, Kielsen K, Burrin DG, Weischendorff S, et al. Gastrointestinal toxicity, systemic inflammation, and liver biochemistry in allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2017;23:1170-6.
27. Hogan WJ, Maris M, Storer B, Sandmaier BM, Maloney DG, Schoch HG, et al. Hepatic injury after nonmyeloablative conditioning followed by allogeneic hematopoietic cell transplantation: a study of 193 patients. Blood 2004;103:78-84.
28. Barba P, Martino R, Perez-Simon JA, Fernandez-Aviles F, Pinana JL, Valcárcel D, et al. Incidence, characteristics and risk factors of marked hyperbilirubinemia after allogeneic hematopoietic cell transplantation with reduced-intensity conditioning. Bone Marrow Transplant 2012;47:1343-9.
29. Maradei SC, Maiolino A, de Azevedo AM, Colares M, Bouzas LF, Nucci M. Serum ferritin as risk factor for sinusoidal obstruction syndrome of the liver in patients undergoing hematopoietic stem cell transplantation. Blood 2009;114:1270-5.
30. Lee SH, Yoo KH, Sung KW, Koo HH, Kwon YJ, Kwon MM, et al. Hepatic veno-occlusive disease in children after hematopoietic stem cell transplantation: incidence, risk factors, and outcome. Bone Marrow Transplant 2010;45:1287-93.
31. Mori J, Ohashi K, Yamaguchi T, Ando M, Hirashima Y, Kobayashi T, et al. Risk assessment for acute kidney injury after allogeneic hematopoietic stem cell transplantation based on Acute Kidney Injury Network criteria. Intern Med 2012;51:2105-10.
32. Kagoya Y, Kataoka K, Nannya Y, Kurokawa M. Pretransplant predictors and posttransplant sequels of acute kidney injury after allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2011;17:394-400.
33. Sadadi F, Najafi I, Hakemi M, Falaknazi K, Atari F, Bahar B. Frequency, risk factors, and outcome of acute kidney injury following bone marrow transplantation at Dr Shariati Hospital in Tehran. Iran J Kidney Dis 2010;4:20-6.
34. Hingorani SR, Guthrie K, Batchelder AM, Schoch G, Aboulhosn N, Manchion J, Mcdonald GB. Acute renal failure after myeloablative hematopoietic cell transplant: incidence and risk factors. Kidney Int 2005;67:272-7.
35. Schrier RW, Parikh CR. Comparison of renal injury in myeloablative autologous, myeloablative allogeneic and non-myeloablative allogeneic haematopoietic cell transplantation. Nephrol Dial Transplant 2005;20:678-83.
36. Caliskan Y, Besisik SK, Sargin D, Ecder T. Early renal injury after myeloablative allogeneic and autologous hematopoietic cell transplantation. Bone Marrow Transplant 2006;38:141-7.
37. Tokgoz B, Kocyigit I, Polat G, Eser B, Unal A, Kaynar L, et al. Acute renal failure after myeloablative allogeneic hematopoietic stem cell transplantation: incidence, risk factors, and relationship with the quantity of transplanted cells. Ren Fail 2010;32:547-54.
38. Parikh CR, McSweeney PA, Korular D, Ecder T, Merouani A, Taylor J, et al. Renal dysfunction in allogeneic hematopoietic cell transplantation. Kid int 2002;62:566-73.
39. Kishi Y, Miyakoshi S, Kami M, Ikeda M, Katayama Y, Murashige N,et al. Early central nervous system complications after reduced-intensity stem cell transplantation. Biol Blood Marrow Transplant 2004;10:561-8.
40. Barba P, Piñana JL, Valcárcel D, Querol L, Martino R, Sureda A, et al. Early and late neurological complications after reduced-intensity conditioning allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2009;15:1439-46.
41. Carreras E, Díaz-Beyá M, Rosiñol L, Martínez C, Fernández-Avilés F, Rovira M. The incidence of veno-occlusive disease following allogeneic hematopoietic stem cell transplantation has diminished and the outcome improved over the last decade. Biol Blood Marrow Transplant 2011;17:1713-20.
42. Zhang L, Chu J, Yu J, Wei W. Cellular and molecular mechanisms in graft‐versus‐host disease. J Leukoc Biol 2016;99:279-87.
| Files | ||
| Issue | Vol 60, No 3 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v60i3.9003 | |
| Keywords | ||
| Allo-HSCT Liver toxicity renal failure Neurotoxicity Transplant Outcomes | ||
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How to Cite
1.
Roshandel E, Hamidpour M, Ghaffari Nazari H, Zamani S, Hassani M, Saeedi A, Hajifathali A. Organ Failure Following Allogeneic Hematopoietic Stem Cell Transplantation and Transplant Outcome Organ Failure. Acta Med Iran. 2022;60(3):156-164.
