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Outcome of children requiring intensive care following haematopoietic SCT for primary immunodeficiency and other non-malignant disorders

Lookup NU author(s): Dr Theresa Cole, Professor Mark Pearce, Dr Barbara Fulton, Professor Andrew Cant, Professor Andrew Gennery, Dr Mary Slatter

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Abstract

Haematopoietic SCT (HSCT) is curative for many children with primary immunodeficiencies or other non-malignant conditions. Outcome for those admitted to intensive care following HSCT for oncology diagnoses has historically been very poor. There is no literature available specifically regarding the outcome for children with primary immunodeficiency requiring intensive care following HSCT. We reviewed our post-HSCT admission to intensive care over a 5-year period. A total of 111 children underwent HSCT. Median age at transplant was 1 year 4 months. The most common diagnosis was SCID. In all, 35% had at least one intensive care admission and 44% survived to be discharged from intensive care. Also, 73% of admission episodes requiring invasive ventilation but no inotropes or renal replacement therapy resulted in survival to discharge. Children undergoing HSCT for immunological diagnoses had a high rate of admission to intensive care. No factors were identified that could predict the need for admission. Invasive ventilation alone has a much better outcome than that in historical series. However, the need for multi-organ system support was still associated with a poor outcome. This information is useful when counselling families of children that have deteriorated and been admitted to intensive care during the HSCT procedure. Bone Marrow Transplantation (2012) 47, 40-45; doi: 10.1038/ bmt. 2011.26; published online 28 February 2011


Publication metadata

Author(s): Cole TS, Johnstone IC, Pearce MS, Fulton B, Cant AJ, Gennery AR, Slatter MA

Publication type: Article

Publication status: Published

Journal: Bone Marrow Transplantation

Year: 2012

Volume: 47

Issue: 1

Pages: 40-45

Print publication date: 28/02/2011

ISSN (print): 0268-3369

ISSN (electronic): 1476-5365

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/bmt.2011.26

DOI: 10.1038/bmt.2011.26


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