Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Elderly Patients With Acute Leukemia Undergoing Haploidentical Hematopoietic Stem Cell Transplantation

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-07-24 DOI:10.1111/ctr.70257

Wei Sun, Shengye Lu, Yaqin Wu, Zhengli Xu, Rui Ma, Xiaodong Mo, Yu Wang, Lanping Xu, Xiaohui Zhang, Xiaojun Huang, Yuqian Sun

{"title":"Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Elderly Patients With Acute Leukemia Undergoing Haploidentical Hematopoietic Stem Cell Transplantation","authors":"Wei Sun, Shengye Lu, Yaqin Wu, Zhengli Xu, Rui Ma, Xiaodong Mo, Yu Wang, Lanping Xu, Xiaohui Zhang, Xiaojun Huang, Yuqian Sun","doi":"10.1111/ctr.70257","DOIUrl":null,"url":null,"abstract":"<div>\n \n <p>We explored the incidence, risk factors, and clinical characteristics of acute kidney injury (AKI) within 100 days posttransplantation, and its impact on the prognosis of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in elderly patients. A total of 224 elderly patients diagnosed with acute leukemia received haplo-HSCT between January 1, 2019, and December 31, 2023 at Peking University People's Hospital. AKI affected 54.9% of the patients, with 33.5% in Stage 1, 18.3% in Stage 2, and 3.1% in Stage 3. Being female and having hypoalbuminemia were independent risk factors for developing severe AKI. Three-year overall survival for AKI Stages 0, 1, 2, and 3 were 73.4%, 75.9%, 56.6%, and 14.3%, respectively (<i>p</i> = 0.000). The 3-year event-free survival rates were 70.7%, 73.0%, 46.2%, and 0% (<i>p</i> < 0.001). The 3-year transplantation-related mortality was 13.8% for Stages 0–1 and 48.1% for Stages 2–3 (<i>p</i> < 0.001). Our study showed that more than half of elderly patients who underwent haplo-HSCT developed AKI. Being female and having hypoalbuminemia before transplantation were at a significantly higher risk for severe AKI. Experiencing Stage 2 or more severe AKI was found to be an independent risk factor for increased mortality.</p>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Transplantation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70257","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

We explored the incidence, risk factors, and clinical characteristics of acute kidney injury (AKI) within 100 days posttransplantation, and its impact on the prognosis of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in elderly patients. A total of 224 elderly patients diagnosed with acute leukemia received haplo-HSCT between January 1, 2019, and December 31, 2023 at Peking University People's Hospital. AKI affected 54.9% of the patients, with 33.5% in Stage 1, 18.3% in Stage 2, and 3.1% in Stage 3. Being female and having hypoalbuminemia were independent risk factors for developing severe AKI. Three-year overall survival for AKI Stages 0, 1, 2, and 3 were 73.4%, 75.9%, 56.6%, and 14.3%, respectively (p = 0.000). The 3-year event-free survival rates were 70.7%, 73.0%, 46.2%, and 0% (p < 0.001). The 3-year transplantation-related mortality was 13.8% for Stages 0–1 and 48.1% for Stages 2–3 (p < 0.001). Our study showed that more than half of elderly patients who underwent haplo-HSCT developed AKI. Being female and having hypoalbuminemia before transplantation were at a significantly higher risk for severe AKI. Experiencing Stage 2 or more severe AKI was found to be an independent risk factor for increased mortality.

查看原文本刊更多论文

单倍体造血干细胞移植治疗老年急性白血病患者急性肾损伤的发生率、危险因素及预后

我们探讨老年患者移植后100天内急性肾损伤（AKI）的发生率、危险因素、临床特征及其对单倍同型造血干细胞移植（haploo - hsct）预后的影响。2019年1月1日至2023年12月31日，224例确诊为急性白血病的老年患者在北京大学人民医院接受了单倍造血干细胞移植。54.9%的患者发生AKI，其中33.5%为一期，18.3%为二期，3.1%为三期。女性和低白蛋白血症是发生严重AKI的独立危险因素。AKI 0期、1期、2期和3期的3年总生存率分别为73.4%、75.9%、56.6%和14.3% （p = 0.000）。3年无事件生存率分别为70.7%、73.0%、46.2%和0% (p <；0.001)。3年移植相关死亡率0-1期为13.8%，2-3期为48.1% (p <；0.001)。我们的研究表明，接受单倍造血干细胞移植的老年患者中有超过一半的人发生了AKI。女性患者和移植前低白蛋白血症患者发生严重AKI的风险明显更高。经历2期或更严重的AKI被发现是死亡率增加的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.