Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation

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Fältnamn	Indikatorer	Metadata
000		09211naa a2200805 4500
001		oai:DiVA.org:uu-446200
003		SwePub
008		210622s2021 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:prod.swepub.kib.ki.se:146688477
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4462002 URI
024	7	a https://doi.org/10.1016/j.jtct.2021.02.0302 DOI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1466884772 URI
040		a (SwePub)uud (SwePub)ki
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Farhadfar, Noshau Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA.4 aut
245	1 0	a Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation
264	1	b Elsevier,c 2021
338		a print2 rdacarrier
520		a Renal dysfunction is a recognized risk factor for mortality after allogeneic hematopoietic cell transplantation (alloHCT), yet our understanding of the effect of different levels of renal dysfunction at time of transplantation on outcomes remains limited. This study explores the impact of different degrees of renal dysfunction on HCT outcomes and examines whether the utilization of incremental degrees of renal dysfunction based on estimated glomerular filtration rate (eGFR) improve the predictability of the hematopoietic cell transplantation comorbidity index (HCT-CI). The study population included 2 cohorts: cohort 1, comprising patients age >= 40 years who under went alloHCT for treatment of hematologic malignancies between 2008 and 2016 (n = 13,505; cohort selected given a very low incidence of renal dysfunction in individuals age <40 years), and cohort 2, comprising patients on dialysis at the time of HCT (n = 46). eGFR was measured using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method. The patients in cohort 1 were assigned into 4 categories-eGFR >= 90 mL/min (n = 7062), eGFR 60 to 89 mL/min (n = 5264), eGFR 45 to 59 mL/min (n = 897), and eGFR <45 mL/min (n=282)-to assess the impact of degree of renal dysfunction on transplantation outcomes. Transplantation outcomes in patients on dialysis at the time of alloHCT were analyzed separately. eGFR <60 mL/min was associated with an increased risk for nonrelapse mortality (NRM) and requirement for dialysis post-HCT. Compared with the eGFR >= 90 group, the hazard ratio (HR) for NRM was 1.46 (P = .0001) for the eGFR 45 to 59 mL/min group and 1.74 (P = .004) for the eGFR <45 mL/min group. Compared with the eGFR >= 90 mL/min group, the eGFR 45 to 59 mL/min group (HR, 2.45; P < .0001) and the eGFR <45 mL/min group (HR, 3.09; P < .0001) had a higher risk of renal failure necessitating dialysis after alloHCT. In addition, eGFR <45 mL/min was associated with an increased overall mortality (HR, 1.63; P < .0001). An eGFR-based revised HCT-CI was also developed and shown to be predictive of overall survival (OS) and NRM, with predictive performance similar to the original HCT-CI. Among 46 patients on dialysis at alloHCT, the 1-year probability of OS was 20%, and that of NRM was 67%. The degree of pretransplantation renal dysfunction is an independent predictor of OS, NRM, and probability of needing dialysis after alloHCT. An eGFR-based HCT-CI is a validated index for predicting outcomes in adults with hematologic malignancies undergoing alloHCT. The outcomes of alloHCT recipients on dialysis are dismal; therefore, one should strongly weigh the significant risks of being on hemodialysis as a factor in determining alloHCT candidacy.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Hematologi0 (SwePub)302022 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Hematology0 (SwePub)302022 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Urologi och njurmedicin0 (SwePub)302142 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Urology and Nephrology0 (SwePub)302142 hsv//eng
653		a Renal dysfunction
653		a HCT-CI
653		a Allogeneic transplantation
653		a Dialysis
700	1	a Dias, Ajoyu Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA.4 aut
700	1	a Wang, Taou Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Equ, Div Biostat, Milwaukee, WI 53226 USA.4 aut
700	1	a Fretham, Caitrinu Natl Marrow Donor Program Be Match, CIBMTR Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN USA.4 aut
700	1	a Chhabra, Saurabhu Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Dept Med, Div Hematol Oncol, Milwaukee, WI 53226 USA.4 aut
700	1	a Murthy, Hemant S.u Mayo Clin, Div Hematol Oncol, Blood & Marrow Transplantat Program, Jacksonville, FL USA.4 aut
700	1	a Broglie, Larisau Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA.4 aut
700	1	a D'Souza, Anitau Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.4 aut
700	1	a Gadalla, Shahinaz M.u NCI, Div Canc Epidemiol & Genet, NIH, Clin Genet Branch, Rockville, MD USA.4 aut
700	1	a Gale, Robert Peteru Imperial Coll London, Haematol Res Ctr, Dept Immunol & Inflammat, London, England.4 aut
700	1	a Hashmi, Shahrukhu Mayo Clin, Dept Internal Med, Rochester, MN USA.;Sheikh Shakhbout Med City, Dept Med, Abu Dhabi, U Arab Emirates.4 aut
700	1	a Al-Homsi, A. Sameru New York Univ Langone Hlth, New York, NY USA.4 aut
700	1	a Hildebrandt, Gerhard C.u Univ Kentucky, Markey Canc Ctr, Lexington, KY USA.4 aut
700	1	a Hematti, Peimanu Univ Wisconsin, Dept Med, Div Hematol Oncol Bone Marrow Transplantat, Madison, WI USA.4 aut
700	1	a Rizzieri, Davidu Duke Univ, Div Hematol Malignancies & Cellular Therapy, Durham, NC USA.4 aut
700	1	a Chee, Lynetteu Royal Melbourne Hosp City Campus, Parkville, Vic, Australia.;Peter MacCallum Canc Ctr, Parkville, Vic, Australia.4 aut
700	1	a Lazarus, Hillard M.u Case Western Reserve Univ, Univ Hosp Cleveland Med Ctr, Cleveland, OH 44106 USA.4 aut
700	1	a Bredeson, Christopheru Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada.;Ottawa Hosp Res Inst, Ottawa, ON, Canada.4 aut
700	1	a Jaimes, Edgar A.u Mem Sloan Kettering Canc Ctr, Renal Serv, 1275 York Ave, New York, NY 10021 USA.4 aut
700	1	a Beitinjaneh, Ameru Univ Miami, Div Transplantat & Cellular Therapy, Miami, FL USA.4 aut
700	1	a Bashey, Asadu Northside Hosp, Blood & Marrow Transplant Program, Atlanta, GA USA.4 aut
700	1	a Prestidge, Timu Starship Childrens Hosp, Blood & Canc Ctr, Auckland, New Zealand.4 aut
700	1	a Krem, Maxwell M.u Univ Kentucky, Coll Med, Markey Canc Ctr, Lexington, KY USA.4 aut
700	1	a Marks, David, Iu Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England.4 aut
700	1	a Benoit, Stefanieu Cincinnati Childrens Hosp Med Ctr, Div Nephrol & Hypertens, Cincinnati, OH 45229 USA.;Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati, OH USA.4 aut
700	1	a Yared, Jean A.u Univ Maryland, Dept Med, Greenebaum Comprehens Canc Ctr, Blood & Marrow Transplantat Program,Div Hematol O, Baltimore, MD 21201 USA.4 aut
700	1	a Nishihori, Taigau H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplant & Cellular Immunot, Tampa, FL USA.4 aut
700	1	a Olsson, Richard F.u Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Karolinska Inst, Dept Lab Med, Stockholm, Sweden4 aut0 (Swepub:uu)riols677
700	1	a Freytes, Cesar O.u Texas Transplant Inst, San Antonio, TX USA.4 aut
700	1	a Stadtmauer, Edwardu Univ Penn, Med Ctr, Abramson Canc Ctr, Philadelphia, PA 19104 USA.4 aut
700	1	a Savani, Bipin N.u Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA.4 aut
700	1	a Sorror, Mohamed L.u Fred Hutchinson Canc Res Ctr, Clin Res Div, Washington, DC USA.;Univ Washington, Sch Med, Dept Med, Div Med Oncol, Seattle, WA 98195 USA.4 aut
700	1	a Ganguly, Siddharthau Univ Kansas Hlth Syst, Div Hematol Malignancy & Cellular Therapeut, Kansas City, KS USA.4 aut
700	1	a Wingard, John R.u Univ Florida, Dept Med, Div Hematol & Oncol, Gainesville, FL USA.4 aut
700	1	a Pasquini, Marcelou Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.4 aut
710	2	a Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA.b Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA.4 org
773	0	t Transplantation and Cellular Therapyd : Elsevierg 27:5, s. 410-422q 27:5<410-422x 2666-6375x 2666-6367
856	4	u https://doi.org/10.1016/j.jtct.2021.02.030
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-446200
856	4 8	u https://doi.org/10.1016/j.jtct.2021.02.030
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:146688477

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