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Incidence, Risk Factors, Outcomes, and Risk Score Model of Acute Pancreatitis after Allogeneic Hematopoietic Stem Cell Transplantation.

Authors :
Wang XL
Han W
Zhao P
Liu X
Wang JZ
Wang FR
Yan CH
Zhang YY
Mo XD
Wang Y
Fu HX
Chen YH
Chang YJ
Xu LP
Liu KY
Huang XJ
Zhang XH
Source :
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2020 Jun; Vol. 26 (6), pp. 1171-1178. Date of Electronic Publication: 2019 Dec 23.
Publication Year :
2020

Abstract

Acute pancreatitis (AP) has been recognized as an uncommon yet potentially lethal complication after hematopoietic stem cell transplant (HSCT). This retrospective, nested, case-control study reviewed data from 5284 consecutive patients who underwent allogeneic (allo)-HSCT between 2009 and 2018 at a single center, identifying 40 patients (0.76%) with AP after allo-HSCT. The diagnosis and severity of AP were established and classified according to existing criteria. Younger age (P = .008), grades II to IV acute graft-versus-host disease (P = .010), a history of donor lymphocyte infusion (P = .033), and pre-existing gallstones (P = .003) were independent risk factors of AP after allo-HSCT. Post-transplant AP had a trend to negatively influence overall survival (OS) and nonrelapse mortality (NRM) (P = .063) for allo-HSCT recipients, but no significant difference was found. Patients with moderately severe and severe AP had significantly lower OS (P = .002) and higher NRM (P = .000) than other patients. Based on these findings, a risk score model was also established to predict the occurrence of AP. Our risk score model performed well in terms of discrimination when applied to derivation samples. Patients were classified into a low-risk group (0 to 1 point), a medium-risk group (2 to 3 points), and a high-risk group (4 points or more). Significant difference was observed in AP incidence among the 3 groups. The predictive tool explored by our study might contribute to target high-risk patients and guide personalized AP prevention in allo-HSCT recipients.<br /> (Copyright © 2019. Published by Elsevier Inc.)

Details

Language :
English
ISSN :
1523-6536
Volume :
26
Issue :
6
Database :
MEDLINE
Journal :
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Publication Type :
Academic Journal
Accession number :
31874219
Full Text :
https://doi.org/10.1016/j.bbmt.2019.12.721