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Early fluid overload predicts higher non-relapse and overall mortality in adults after single-unit cord blood transplantation

Bone Marrow Transplantation volume 54, pages 2096–2101 (2019)Cite this article

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Abstract

Early fluid overload has been associated with poor transplant outcomes after allogeneic hematopoietic cell transplantation. However, its effects on the outcomes after cord blood transplantation (CBT) are unclear. We retrospectively analyzed the data of 227 adult patients who received single-unit CBT in our institute. The cumulative incidence of grade ≥2 fluid overload was 4% at day 30 after CBT with a median onset at 16 days (range, 9–30 days) after CBT. In the multivariate analysis, grade ≥2 fluid overload was significantly associated with higher non-relapse mortality (hazard ratio [HR], 5.73; P = 0.011) and overall mortality (HR, 3.81; P = 0.006). Among the entire cohort, 133 patients were treated with low-dose dopamine (0.5–2 µg/kg/min) with a median time of initiation of low-dose dopamine therapy at 10.5 days after CBT. Use of low-dose dopamine significantly increased daily urine output and decreased body weight. These data suggested that early fluid overload was significantly associated with non-relapse and overall mortality after single CBT. The early intervention of low-dose dopamine to prevent early fluid overload is a matter of future investigation for patients undergoing allogeneic hematopoietic cell transplantations (HCT), particularly for CBT.

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Acknowledgements

The authors thank all of the physicians and staff at the hospital and the cord blood banks in Japan for their help in this study.

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  1. Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Takaaki Konuma, Maki Oiwa-Monna, Mai Mizusawa, Masamichi Isobe, Seiko Kato, Satoshi Takahashi & Arinobu Tojo

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  1. Takaaki Konuma
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  2. Maki Oiwa-Monna
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  3. Mai Mizusawa
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  4. Masamichi Isobe
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Correspondence to Takaaki Konuma.

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Konuma, T., Oiwa-Monna, M., Mizusawa, M. et al. Early fluid overload predicts higher non-relapse and overall mortality in adults after single-unit cord blood transplantation. Bone Marrow Transplant 54, 2096–2101 (2019). https://doi.org/10.1038/s41409-019-0634-x

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