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A retrospective study of treatment and outcomes of patients with lymphoma undergoing hematopoietic stem cell transplantation: A single-center experience
Affiliation:1. Clinical Hospital, Kidney Transplant Unit, Belo Horizonte, MG, Brazil;2. Faculty of the Hospital Santa Casa, Belo Horizonte, MG, Brazil;3. IMUNOLAB – Laboratory of Transplant Immunology, Belo Horizonte, MG, Brazil;4. Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, MG, Brazil;5. Clinical Hospital of Porto Alegre, Rio Grande do Sul, Brazil;6. Mater Dei Hospital Minas Gerais, Belo Horizonte, MG, Brazil;7. Biocor Hospital, Belo Horizonte, Minas Gerais, Brazil;1. Department of Pediatrics "C", Schneider Children''s Medical Center of Israel, Petah Tikva, Israel;2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;3. Department of Pediatric Emergency Medicine, Schneider Children''s Medical Center of Israel, Petah Tikva, Israel;4. Pediatric Infectious Disease Unit, Day Hospitalization Department, Schneider Children''s Medical Center of Israel, Petah Tikva, Israel;5. Institute of Nephrology, Schneider Children''s Medical Center of Israel, Petah Tikva, Israel;1. Department of Transfusion Medicine, Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, Tamilnadu, India;2. Liver Anesthesia & Intensive care, Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, Tamilnadu, India;3. HPB Surgery & Liver Transplantation, Institute of Liver Disease and Transplantation, Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, Tamilnadu, India
Abstract:BackgroundEarly evaluation of symptoms and taking appropriate preventive measures can improve outcomes for patients with lymphoma undergoing hematopoietic stem cell transplantation (HSCT). This study aimed to examine the treatment and outcomes of patients with lymphoma undergoing HSCT.MethodsPatients with lymphoma undergoing SCT at a university hospital between 15.06.2018 and 15.06.2020, were selected for a retrospective study. The medical treatments of patients were obtained from the records on the Hospital Information Management System (HIMS) database. The study was reported following the STROBE checklist.ResultsSixty-four patients were analyzed. The mean age of the patients was 48.25 ± 16.93 (p = 0.76). Although relapse developed in 26 (40.6%) patients with lymphoma, remission was achieved in 38 (59.4%) patients. The incidence of skin graft-versus-host disease (GVHD) symptoms in patients with relapse [14(53.8%)] was found to be significantly higher than in patients in remission [4(10.5%)] (p < 0.001). The most common symptoms seen in patients undergoing HSCT were oral mucositis (78.1%), febrile neutropenia (68.8%), and anemia (56.3%). In the treatments applied after SCT, the administration of antifungal (p = 0.033), analgesic (p = 0.001), and anticoagulant (p = 0.008) treatments to the patients who were in remission compared with the relapsed patients was significant. Less courses (OR: 0.446; 95% CI: 0.22–0.907; p = 0.026), analgesic therapy (OR:6.22; 95% CI: 1.61–24.027; p = 0.008), and anticoagulant treatment (OR:7.13; %) 95 CI: 1.374–37.1; p = 0.019) were found to increase the risk of relapse. Because of the increase in the number of cures in SCT, the incidence of diarrhea (p = 0.016) and GIS GVHD (p = 0.022) was high. It was determined that the hospitalization period was shorter in patients with febrile neutropenia (p = 0.021), thrombocytopenia/bleeding (p = 0.031), and secretion (p = 0.036) symptoms.ConclusionsPatients experienced severe symptoms such as oral mucositis, febrile neutropenia, and anemia due to HSCT, and necessary treatment was applied for the symptoms. Further clinical studies must determine the symptoms and patient outcomes associated with SCT. It is predicted that patients will benefit from regular follow-up of their symptoms and planning of appropriate evidence-based nursing interventions and that this will improve the quality of care to be offered to them and increase their life span.
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