title: Mortality of Oncohematological Patients Undergoing Hematopoietic Stem Cell Transplantation Admitted to the Intensive Care Unit.
abstract: BACKGROUND
  Both autologous and allogenic hematopoietic stem cell transplantation (HSCT) are potentially curative treatments for hematological malignancies. Patients with related complications may need admission to the intensive care unit (ICU) for specific therapy and organ support. A consensus on treatment between hematologists and intensive care specialists is essential.
  
  
  METHODS
  This observasional, retrospective study included all recipients of HSCT in a third-level hospital during 2013 and 2014. Certain parameters were taken into account for patients who needed to be admitted to the ICU, evolution, and ICU and hospital mortality.
  
  
  RESULTS
  A total of 228 HSCT were carried out: 127 autologous (55.7%) and 101 allogenic (44.3%). Twenty-four patients were admitted to the ICU; 22 had received allogenic HSCT and 2 autologous. The main underlying conditions were acute leukemias (41.6%) and myelodysplastic syndromes (20.8%). Of these patients, 45.8% were in complete remission and 33.3% were in relapse or progression. Causes of admission to the ICU were mainly respiratory failure (70.8%) followed by shock requiring vasoactive drugs. High values for severity scores were observed for APACHE II 25 (19-28) and SOFA 10 (8-14). During hospitalization, a high percentage of patients had hemodynamic (91.7%), renal (87.5%), hepatic (79.2%), and respiratory (87.5%) failure. Mortality in the ICU was 83.3% and hospitalary, 91.7%. All patients requiring invasive mechanical ventilation died in the ICU.
  
  
  CONCLUSIONS
  Of recipient patients of allogenic HSCT, 21.8% were admitted to the ICU, presenting a mortality rate of >95%. The main reason for admission was respiratory failure with requirement of invasive mechanical ventilation. Patients with autologous HSCT presented very few complications needing organ support.
authors.affiliation: Intensive Care Unit Service, UH Virgen del Rocío, Seville, Spain. Electronic address: yaelcorcia@gmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Corcía Palomo
authors.affiliation: Haematology and Haemotherapy Service, UH Virgen del Rocío, Seville, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Knight Asorey
authors.affiliation: Haematology and Haemotherapy Service, UH Virgen del Rocío, Seville, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Espigado
authors.affiliation: Intensive Care Unit Service, UH Virgen del Rocío, Seville, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Martín Villén
authors.affiliation: Intensive Care Unit Service, UH Virgen del Rocío, Seville, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Garnacho Montero
mesh_terms: D000328:Adult; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends