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.