CLINICAL CHARACTERSTICS AND RISK FACTORS OF INTRACRANIAL HAEMORRHAGE IN PATIENTS FOLLOWING ALLOGENEIC HAEMATOPOIETIC STEM CELL TRANSPLANTATION
(Abstract release date: 05/21/15)
EHA Library. Zhang X. 06/13/15; 103100; S499
Disclosure(s): Peking University People’s HospitalPeking University Institute of Hematology
Prof. Xiaohui Zhang
Contributions
Contributions
Abstract
Abstract: S499
Type: Oral Presentation
Presentation during EHA20: From 13.06.2015 16:30 to 13.06.2015 16:45
Location: Room Stolz 1
Background
Aims
Methods
A nested case–control study was conducted that included 175 subjects obtained from 2165 subjects who underwent HSCT in Peking University People’s Hospital between Sept. 2004 and Jul. 2014. In total, 35 patients with ICH and 140 controls matched for age, sex, transplantation type and time after transplantation were identified (total n=175). The incidence of ICH was identified by searching hospital records of CT and MRI scans.
Results
Among the 2165 patients, 35 patients (1.6%) developed intracranial haemorrhage, including 29 cases (82.9%) of intraparenchymal haemorrhage (IPH), 2 cases (5.7%) of subdural haematoma (SDH), 1 case (2.9%) of subarachnoid haemorrhage (SAH), and 3 cases (8.6%) of multiple haemorrhage lesions in the brain parenchyma. The median time of appearance for cerebral haemorrhages was 129 days (range, 1-450 days). ICH patients exhibited unique characteristics compared with controls, including systemic infections, severe graft versus host disease (GvHD), and coagulation disorders. Multivariate analysis revealed that systemic infections, III-IV acute GvHD, lower platelet count and fibrinogen levels are independent risk factors for ICH among HSCT patients. The risk of ICH increases when platelet counts are below 13.2×10^9/L and fibrinogen is below 129.5 g/L. However, in addition to the causes indicated above, chronic GvHD, hypertension, central nervous system leukaemia, and INR were identified as risk factors by universal analysis. Transplantation-related mortality rates in the intracranial haemorrhage and control groups were 50% and 22.2%, respectively. The cumulative survival rates in the intracranial haemorrhage and control groups were 47.1% and 75.7% (P<0.001).
Summary
ICH is one of the most common cerebral complications after HSCT and is associated with a high mortality and reduced overall survival rate. Systemic infections, III-IV acute GvHD, lower platelet count, and lower fibrinogen levels are individual independent risk factors. To prevent ICH, it is useful to increase platelet counts and fibrinogen to safe levels.
Keyword(s): Allogeneic hematopoietic stem cell transplant, Bleeding, Risk factor
Session topic: Platelet and bleeding disorders
Type: Oral Presentation
Presentation during EHA20: From 13.06.2015 16:30 to 13.06.2015 16:45
Location: Room Stolz 1
Background
Although cerebral complications and causes after allogeneic haematopoietic stem cell transplantation (allo-HSCT) are well documented, assessment of incidence rates and risk factors of intracranial haemorrhage (ICH) following allo-HSCT are less frequently reported (Najima et al., Am J Hematol 2009).
Aims
The aim of this study is to determine the clinical characteristics, risk factors and prognosis of ICH following allo-HSCT.
Methods
A nested case–control study was conducted that included 175 subjects obtained from 2165 subjects who underwent HSCT in Peking University People’s Hospital between Sept. 2004 and Jul. 2014. In total, 35 patients with ICH and 140 controls matched for age, sex, transplantation type and time after transplantation were identified (total n=175). The incidence of ICH was identified by searching hospital records of CT and MRI scans.
Results
Among the 2165 patients, 35 patients (1.6%) developed intracranial haemorrhage, including 29 cases (82.9%) of intraparenchymal haemorrhage (IPH), 2 cases (5.7%) of subdural haematoma (SDH), 1 case (2.9%) of subarachnoid haemorrhage (SAH), and 3 cases (8.6%) of multiple haemorrhage lesions in the brain parenchyma. The median time of appearance for cerebral haemorrhages was 129 days (range, 1-450 days). ICH patients exhibited unique characteristics compared with controls, including systemic infections, severe graft versus host disease (GvHD), and coagulation disorders. Multivariate analysis revealed that systemic infections, III-IV acute GvHD, lower platelet count and fibrinogen levels are independent risk factors for ICH among HSCT patients. The risk of ICH increases when platelet counts are below 13.2×10^9/L and fibrinogen is below 129.5 g/L. However, in addition to the causes indicated above, chronic GvHD, hypertension, central nervous system leukaemia, and INR were identified as risk factors by universal analysis. Transplantation-related mortality rates in the intracranial haemorrhage and control groups were 50% and 22.2%, respectively. The cumulative survival rates in the intracranial haemorrhage and control groups were 47.1% and 75.7% (P<0.001).
Summary
ICH is one of the most common cerebral complications after HSCT and is associated with a high mortality and reduced overall survival rate. Systemic infections, III-IV acute GvHD, lower platelet count, and lower fibrinogen levels are individual independent risk factors. To prevent ICH, it is useful to increase platelet counts and fibrinogen to safe levels.
Keyword(s): Allogeneic hematopoietic stem cell transplant, Bleeding, Risk factor
Session topic: Platelet and bleeding disorders
Abstract: S499
Type: Oral Presentation
Presentation during EHA20: From 13.06.2015 16:30 to 13.06.2015 16:45
Location: Room Stolz 1
Background
Aims
Methods
A nested case–control study was conducted that included 175 subjects obtained from 2165 subjects who underwent HSCT in Peking University People’s Hospital between Sept. 2004 and Jul. 2014. In total, 35 patients with ICH and 140 controls matched for age, sex, transplantation type and time after transplantation were identified (total n=175). The incidence of ICH was identified by searching hospital records of CT and MRI scans.
Results
Among the 2165 patients, 35 patients (1.6%) developed intracranial haemorrhage, including 29 cases (82.9%) of intraparenchymal haemorrhage (IPH), 2 cases (5.7%) of subdural haematoma (SDH), 1 case (2.9%) of subarachnoid haemorrhage (SAH), and 3 cases (8.6%) of multiple haemorrhage lesions in the brain parenchyma. The median time of appearance for cerebral haemorrhages was 129 days (range, 1-450 days). ICH patients exhibited unique characteristics compared with controls, including systemic infections, severe graft versus host disease (GvHD), and coagulation disorders. Multivariate analysis revealed that systemic infections, III-IV acute GvHD, lower platelet count and fibrinogen levels are independent risk factors for ICH among HSCT patients. The risk of ICH increases when platelet counts are below 13.2×10^9/L and fibrinogen is below 129.5 g/L. However, in addition to the causes indicated above, chronic GvHD, hypertension, central nervous system leukaemia, and INR were identified as risk factors by universal analysis. Transplantation-related mortality rates in the intracranial haemorrhage and control groups were 50% and 22.2%, respectively. The cumulative survival rates in the intracranial haemorrhage and control groups were 47.1% and 75.7% (P<0.001).
Summary
ICH is one of the most common cerebral complications after HSCT and is associated with a high mortality and reduced overall survival rate. Systemic infections, III-IV acute GvHD, lower platelet count, and lower fibrinogen levels are individual independent risk factors. To prevent ICH, it is useful to increase platelet counts and fibrinogen to safe levels.
Keyword(s): Allogeneic hematopoietic stem cell transplant, Bleeding, Risk factor
Session topic: Platelet and bleeding disorders
Type: Oral Presentation
Presentation during EHA20: From 13.06.2015 16:30 to 13.06.2015 16:45
Location: Room Stolz 1
Background
Although cerebral complications and causes after allogeneic haematopoietic stem cell transplantation (allo-HSCT) are well documented, assessment of incidence rates and risk factors of intracranial haemorrhage (ICH) following allo-HSCT are less frequently reported (Najima et al., Am J Hematol 2009).
Aims
The aim of this study is to determine the clinical characteristics, risk factors and prognosis of ICH following allo-HSCT.
Methods
A nested case–control study was conducted that included 175 subjects obtained from 2165 subjects who underwent HSCT in Peking University People’s Hospital between Sept. 2004 and Jul. 2014. In total, 35 patients with ICH and 140 controls matched for age, sex, transplantation type and time after transplantation were identified (total n=175). The incidence of ICH was identified by searching hospital records of CT and MRI scans.
Results
Among the 2165 patients, 35 patients (1.6%) developed intracranial haemorrhage, including 29 cases (82.9%) of intraparenchymal haemorrhage (IPH), 2 cases (5.7%) of subdural haematoma (SDH), 1 case (2.9%) of subarachnoid haemorrhage (SAH), and 3 cases (8.6%) of multiple haemorrhage lesions in the brain parenchyma. The median time of appearance for cerebral haemorrhages was 129 days (range, 1-450 days). ICH patients exhibited unique characteristics compared with controls, including systemic infections, severe graft versus host disease (GvHD), and coagulation disorders. Multivariate analysis revealed that systemic infections, III-IV acute GvHD, lower platelet count and fibrinogen levels are independent risk factors for ICH among HSCT patients. The risk of ICH increases when platelet counts are below 13.2×10^9/L and fibrinogen is below 129.5 g/L. However, in addition to the causes indicated above, chronic GvHD, hypertension, central nervous system leukaemia, and INR were identified as risk factors by universal analysis. Transplantation-related mortality rates in the intracranial haemorrhage and control groups were 50% and 22.2%, respectively. The cumulative survival rates in the intracranial haemorrhage and control groups were 47.1% and 75.7% (P<0.001).
Summary
ICH is one of the most common cerebral complications after HSCT and is associated with a high mortality and reduced overall survival rate. Systemic infections, III-IV acute GvHD, lower platelet count, and lower fibrinogen levels are individual independent risk factors. To prevent ICH, it is useful to increase platelet counts and fibrinogen to safe levels.
Keyword(s): Allogeneic hematopoietic stem cell transplant, Bleeding, Risk factor
Session topic: Platelet and bleeding disorders
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