دورية أكاديمية
Pulmonary hypertension in the intensive care unit after pediatric allogeneic hematopoietic stem cell transplant: incidence, risk factors, and outcomes.
| العنوان: | Pulmonary hypertension in the intensive care unit after pediatric allogeneic hematopoietic stem cell transplant: incidence, risk factors, and outcomes. |
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| المؤلفون: | Smith MA; Department of Pediatrics, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, CA, United States., Cheng G; Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of California, San Francisco, San Francisco, CA, United States., Phelan R; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States., Brazauskas R; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States., Strom J; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States., Ahn KW; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States., Hamilton BK; Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, United States., Peterson A; Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States., Savani B; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States., Schoemans H; Department of Haematology, University Hospital Gasthuisberg, Leuven, Belgium., Schoettler ML; Children's Healthcare of Atlanta, Emory University, Atlanta, GA, United States., Sorror M; Department of Hematology-Oncology, Fred Hutchinson Cancer Center, Seattle, WA, United States., Keller RL; Department of Pediatrics, Division of Neonatology, University of California, San Francisco, San Francisco, CA, United States., Higham CS; Department of Pediatrics, Division of Allergy, Immunology, and BMT, University of California, San Francisco, San Francisco, CA, United States., Dvorak CC; Department of Pediatrics, Division of Allergy, Immunology, and BMT, University of California, San Francisco, San Francisco, CA, United States., Fineman JR; Department of Pediatrics, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, CA, United States., Zinter MS; Department of Pediatrics, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, CA, United States.; Department of Pediatrics, Division of Allergy, Immunology, and BMT, University of California, San Francisco, San Francisco, CA, United States. |
| المصدر: | Frontiers in oncology [Front Oncol] 2024 May 29; Vol. 14, pp. 1415984. Date of Electronic Publication: 2024 May 29 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Frontiers Research Foundation] Country of Publication: Switzerland NLM ID: 101568867 Publication Model: eCollection Cited Medium: Print ISSN: 2234-943X (Print) Linking ISSN: 2234943X NLM ISO Abbreviation: Front Oncol Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Lausanne : Frontiers Research Foundation] |
| مستخلص: | Objective: To determine the incidence, risk factors, and outcomes of pulmonary hypertension (PH) in the pediatric intensive care unit (PICU) after pediatric hematopoietic stem cell transplant (HCT). Methods: This was a retrospective study of pediatric patients who underwent allogeneic HCT between January 2008-December 2014 at a center contributing to the Center for International Blood and Marrow Transplant Research data registry. Incidence of PH was assessed from PICU diagnostic codes from records merged from the Virtual Pediatric Systems database. Regression and survival analyses identified factors associated with post-HCT PH. Additional post-HCT morbidities and survival after PH were also assessed. Results: Among 6,995 HCT recipients, there were 29 cases of PH, a cumulative incidence of 0.42% (95% CI 0.27%-0.57%) at 60 months post-HCT. In the sub-cohort of 1,067 patients requiring intensive care after HCT, this accounted for a PH prevalence of 2.72% (95% CI 1.74-3.69%). There was an increased risk of developing PH associated with Black/African American race, metabolic disorders, partially HLA-matched or cord blood allografts, graft-versus-host prophylaxis regimen, and lower pre-HCT functional status. Patients who developed PH had significant PICU comorbidities including heart failure, pulmonary hemorrhage, respiratory failure, renal failure, and infections. Survival at 6 months after diagnosis of post-HCT PH was 51.7% (95% CI 32.5%-67.9%). Conclusions: PH is a rare but serious complication in the pediatric post-HCT population. A significant burden of additional comorbidities, procedural interventions, and risk of mortality is associated with its development. Close monitoring and prompt intervention for this severe complication are necessary in this vulnerable population. Competing Interests: RP reports bluebird bio: advisory board and Amgen: research funding. BH reports ad hoc advisory boards for Nkarta, Sanofi, Incyte, Rigel, Maat; consultancy with ACI Group, Therakos/Mallinkrodt speaker fees; data safety monitoring committee for Angiocrine; adjudication committee with CSL Behring. HS reports having received personal fees from Incyte, Janssen, Novartis, Sanofi and from the Belgian Hematological Society BHS paid to her institution; and serves as a volunteer for the EBMT. MSc reports consulting and honorarium from Omeros and Alexion. MSo reports receiving honoraria from JAZZ Pharmaceuticals Canada and research funding per a contract with Massachusetts General Hospital. CD reports consulting for Alexion and Jazz Pharmaceuticals. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (Copyright © 2024 Smith, Cheng, Phelan, Brazauskas, Strom, Ahn, Hamilton, Peterson, Savani, Schoemans, Schoettler, Sorror, Keller, Higham, Dvorak, Fineman and Zinter.) |
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| معلومات مُعتمدة: | T32 CA128583 United States CA NCI NIH HHS |
| فهرسة مساهمة: | Keywords: critical care; pediatrics; pulmonary hypertension; pulmonary vascular disease; stem cell transplant |
| تواريخ الأحداث: | Date Created: 20240613 Latest Revision: 20240702 |
| رمز التحديث: | 20240702 |
| مُعرف محوري في PubMed: | PMC11167102 |
| DOI: | 10.3389/fonc.2024.1415984 |
| PMID: | 38868534 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2234-943X |
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| DOI: | 10.3389/fonc.2024.1415984 |