Mortality and associated factors in post-stem cell transplant patients: a two-year cohort in a public hospital in Peru.

Abstract

Objective.: To determine mortality and associated factors in patients who received an allogeneic hematopoietic stem cell transplant at the Hospital Nacional Edgardo Rebagliati Martins, between January 2017 and December 2022.

Materials and methods.: A retrospective cohort study was conducted on patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) between 2017 and 2022. Death at one hundred days and two years, and its associated factors, were evaluated. Proportional Cox regression models were used.

Results.: 342 post-HSCT patients were included, with a median age of 23 years (interquartile range: 10 to 39), of whom 53.5% were women. The most frequent diagnosis for the transplant was acute lymphoblastic leukemia at 54.1%. Mortality in the first 100 days post-HSCT was 8.2%, and at two years was 30.4%. In the multivariate regression at one hundred days, factors associated with a higher risk of mortality were age over 50 years (HRa: 6.97; 95% CI: 1.18-41.23), being a recipient of a haploidentical transplant (HRa: 3.57; 95% CI: 1.13-11.24), and sepsis as a complication (HRa: 68.78; 95% CI: 19.32-244.84). In the two-year analysis, acute myeloid leukemia (1.72; IC 95%: 1.08-2.74), haploidentical transplant (HRa:1.81; 95%CI: 1.21-2.72), and disease relapse (HRa: 4.17; 95%CI%: 2.75-6.31) were associated with a higher risk of death.

Conclusions.: The mortality found was low and similar to that of countries with higher incomes; however, it is necessary to formulate interventions that reduce the incidence of modifiable factors such as sepsis.