Analysis of factors associated with hematopoietic stem-cell retransplantation: a case-control study
DOI:
https://doi.org/10.1590/1518-8345.5794.3569Keywords:
Graft Rejection; Recurrence; Hematopoietic Stem Cell Transplantation; Bone Marrow Transplantation; Survival Analysis; Analytical Epidemiology.Abstract
Objective: to analyze the factors associated with the failure of
Hematopoietic Stem Cell Transplantation (HSCT) in patients undergoing
Hematopoietic Stem Cell Retransplantation (HSCR). Method: this
study implemented a quantitative approach and was a case-control
type which addressed patients undergoing HSCR. To do so, a paired
sample of two controls was used for each case (2:1). The case group
consisted of the medical records of all patients who underwent HSCR
(28) and the control group (56) of those who underwent only one
transplant. Three variables guided the pairing: gender, diagnosis
and type of transplant. Results: a total of 24 (85.71%) patients in
the case group were re-transplanted due to disease relapse and four
(14.29%) due to graft failure. There was a statistical difference in
the analysis between patients who did not use ursodeoxycholic acid,
opioid analgesics and immunosuppressants. The need for HSCR among
those who used these medications inappropriately was 16.12, 12.79
and 4.5 times more likely, respectively, than those who used them
correctly. Conclusion: there was a difference regarding the reasons
which led to the retransplantation and the analyzed subjects, and
this study concluded that the predictive reason for retransplantation
in the studied sample was disease relapse.
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