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Post-Transplant Complications

Acute renal failure requiring dialysis after allogeneic blood and marrow transplantation identifies very poor prognosis patients

Bone Marrow Transplantation volume 32, pages 405–410 (2003)Cite this article

Summary:

We examined the incidence, risk factors and associated mortality of acute renal failure requiring dialysis (Renal Bearman Grade [BG] 3) in a 3-year cohort of 97 consecutive allogeneic blood and marrow transplantation (alloBMT) patients. In all, 20 (21%) developed Renal BG3 (all died by day +132) and 77 (79%) developed renal insufficiency (Renal BG1-2). Renal BG3 was a contributing or primary cause of death in 18 (90%) patients who continued to require dialysis at time of death. The two Renal BG3 patients whose deaths were not related to renal failure died on day +103 of hemorrhage and day +132 of underlying disease. By univariate analysis, age, unrelated donor, veno-occlusive disease (VOD) and grade III–IV acute graft-versus-host disease with hepatic involvement were significantly associated with Renal BG3. The multivariate model of time to Renal BG3 determined only a prior diagnosis of severe acute GVHD (RR=4.1, 95% CI 1.6–10.3, P=0.003) and VOD (RR=9.1, 95% CI 3.5–23.7, P<0.001) as significant independent predictors. Renal BG3 is generally considered a conditioning regimen-related toxicity. This study demonstrates that Renal BG3 is most commonly a complication of hepatic co-morbidities after allogeneic blood and marrow transplantation and identifies patients with a very poor prognosis.

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Authors and Affiliations

  1. Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA

    T Hahn, A Miller, A R Alam, M R Baer, Z Bernstein, A A Chanan-Khan, M S Czuczman, J Slack, M Wetzler, B K Mookerjee & P L McCarthy Jr

  2. Nursing, Roswell Park Cancer Institute, Buffalo, NY, USA

    C Rondeau

  3. Department of Medicine, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, NY, USA

    A Shaukat & V Jupudy

  4. Department of Pediatric Oncology, Buffalo, NY, USA

    B Bambach

  5. Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA

    J Silva

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  1. T Hahn
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Hahn, T., Rondeau, C., Shaukat, A. et al. Acute renal failure requiring dialysis after allogeneic blood and marrow transplantation identifies very poor prognosis patients. Bone Marrow Transplant 32, 405–410 (2003). https://doi.org/10.1038/sj.bmt.1704144

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  • DOI: https://doi.org/10.1038/sj.bmt.1704144

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