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

摘要

Objective assessment of organ toxicity that occurs after hemato-poietic SCT (HSCT) typically employs grading schemes that describe peak toxicities in individual organs using validated seventy scores. 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.