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Risk Factors

                                                                                    HCT Transplantation: Version 7.0

Risk Factors Associated with Decreased Survival Following HCT

Patient survival can be looked at over two time intervals: the first 100 days following initiation of ablative therapy or the conditioning regimen in the case of non-myeloablative transplants and one-year following the transplant. The factors that influence the outcome are different in these two phases of recovery.

First 100 Days:
        •    Age.  Younger patients do better than older patients.  The basic cohorts
              are < 20 years, 20-55 years and > 55 years
        •    Condition of the patient at the time of transplant
        •    Underlying diagnosis
        •    Treatment toxicity
        •    Consequences of pancytopenia and profound immunosuppression, such
              as infection, hemorrhage, impaired nutrition, etc.
        •    Failure to engraft
        •    Severe acute GVHD
        •    Center specific issues: knowledge and experience of the team, facility factors,
              consultants who are knowledgeable about transplant patients, etc

First Year:
        •    Acute and chronic GVHD
        •    Complications of immunosuppression
        •    Failure of engraftment or incomplete marrow recovery
        •    Post-transplant lymphoproliferative disease (PTLD)
        •    Disease recurrence
        •    Compliance
        •    Lack of psychosocial support

In general, if patients survive the first one to two years following allogeneic HCT, they tend to have a favorable outlook.  We suggest that clients familiarize themselves with these outcomes for your use when counseling plan members. Click here for a comprehensive guide to the latest outcomes data by disease.

The most current available survival information is presented here. Another excellent source for detailed information about stem cell transplantation in general is the CIBMTR annual report. It can be found here.