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Incidence, clinical features, and risk factors of idiopathic pneumonia syndrome following hematopoietic stem cell transplantation in children
Author(s) -
Sakaguchi Hirotoshi,
Takahashi Yoshiyuki,
Watanabe Nobuhiro,
Doisaki Sayoko,
Muramatsu Hideki,
Hama Asahito,
Shimada Akira,
Yagasaki Hiroshi,
Kudo Kazuko,
Kojima Seiji
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.23298
Subject(s) - medicine , hematopoietic stem cell transplantation , cumulative incidence , busulfan , incidence (geometry) , confidence interval , transplantation , pneumonia , surgery , pediatrics , physics , optics
Background Idiopathic pneumonia syndrome (IPS) is a severe complication that can occur after hematopoietic stem cell transplantation (HSCT) and is often associated with a fatal outcome despite intensive supportive care. Procedure To assess the incidence and risk factors of IPS, we reviewed 251 consecutive patients (median age, 7.0 years) who received HSCT at the Department of Pediatrics, Nagoya University Hospital, between January 1990 and July 2009. Results Twenty of 251 (cumulative incidence of IPS at 2 years after HSCT, 8.0%; 95% confidence interval (CI), 5.1–12.4%) patients developed IPS. The median duration from HSCT to diagnosis of IPS was 67 days (range, 12–486 days). Patients with IPS had significantly higher 5‐year transplant‐related mortality compared to patients without IPS (52% (95% CI, 19–77%) vs. 13% (95% CI, 5–25%), P < 0.001), and the probability of 5‐year overall survival was significantly worse for patients with IPS (42% (95% CI, 25–64%) vs. 68% (95% CI, 59–76%), P = 0.01). By multivariate analysis, high risk in underlying disease (HR, 2.5; 95% CI, 1.0–6.7; P = 0.05) and a busulfan‐containing regimen (HR, 3.5; 95% CI, 1.3–9.9; P < 0.01) were identified as the independent risk factors for developing IPS. Conclusion The prophylactic strategies for IPS in patients with these risk factors were warranted. Pediatr Blood Cancer 2012; 58: 780–784. © 2011 Wiley Periodicals, Inc.