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Serial assessment of toxicity after hematopoietic SCT can discern kinetics of transplant-related organ injury and patterns of recovery

Bone Marrow Transplantation volume 47, pages 1375–1376 (2012)Cite this article

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Objective assessment of organ toxicity that occurs after hematopoietic SCT (HSCT) typically employs grading schemes that describe peak toxicities in individual organs using validated severity scores.1, 2, 3, 4 In addition, global measures of transplant-related toxicity may include total length of hospital admission, the need for transfer to intensive care5 and non-relapse mortality at 100 days. None of these toxicity measures, however, provide insight regarding the timing or the recovery from organ damage. Herein, we describe the use of serial toxicity assessments as a tool to assess the toxicity as well as the rate and extent of functional recovery following HSCT.

Consecutive patients undergoing HSCT at the Ottawa Hospital between April and August 2009 and who provided consent were included in the study. Patients undergoing allogeneic HSCT received MTX on days 1, 3, 6 and 11, and calcineurin inhibitors after transplant to prevent GVHD unless contraindicated. Patients undergoing unrelated donor allogeneic HSCT also received antithymocyte antiglobulin 2.5 mg/kg, as GVHD prophylaxis. Patients receiving TBI as part of the conditioning regimen received keratinocyte growth factor before transplantation to reduce oral mucositis (OM).6 The severity of transplant-related organ toxicity was assessed in accordance with previously published severity scales1 and determined daily beginning on the first day after stem cell infusion and continued until hospital discharge or death.

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Authors and Affiliations

  1. Department of Medicine, The Blood and Marrow Transplant Program, The Ottawa Hospital, Ottawa, Ontario, Canada

    A Chou, M Guo, J Tay, H Atkins, I Bence-Bruckler, M Sabloff, L Huebsch & D Allan

  2. Department of Medicine, The University of Ottawa, Ottawa, Ontario, Canada

    J Tay, H Atkins, I Bence-Bruckler, M Sabloff, L Huebsch & D Allan

  3. Department of Biochemistry, Microbiology & Immunology, The University of Ottawa, Ottawa, Ontario, Canada

    D Allan

  4. Sprott Centre for Stem Cell Research, Regenerative Medicine Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

    D Allan

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  1. A Chou
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  2. M Guo
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  3. J Tay
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  4. H Atkins
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  5. I Bence-Bruckler
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  6. M Sabloff
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  7. L Huebsch
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  8. D Allan
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Correspondence to D Allan.

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Chou, A., Guo, M., Tay, J. et al. Serial assessment of toxicity after hematopoietic SCT can discern kinetics of transplant-related organ injury and patterns of recovery. Bone Marrow Transplant 47, 1375–1376 (2012). https://doi.org/10.1038/bmt.2012.27

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