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Analysis of incidence, risk factors and clinical outcome of thromboembolic and bleeding events in 431 allogeneic hematopoietic stem cell transplantation recipients

AutorLabrador, Jorge; López-Anglada, Lucía; Lozano, Francisco S.; López-Corral, L.; Sánchez-Guijo, Fermín M.; Vázquez, Lourdes; Pérez-Rivera, José Ángel; Martin-Herrero, Francisco; Guerrero Arroyo, María del Carmen ; Cañizo, María Consuelo del; Caballero, Maria Dolores; San Miguel, Jesús F. ; González-Porras, José R.
Fecha de publicación2013
EditorFerrata Storti Foundation
CitaciónHaematologica 98(3): 437-443 (2013)
ResumenAllogeneic hematopoietic stem cell transplantation recipients have an increasing risk of both hemorrhagic and thrombotic complications. However, the competing risks of two of these life-threatening complications in these complex patients have still not been well defined. We retrospectively analyzed data from 431 allogeneic transplantation recipients to identify the incidence, risk factors and mortality due to thrombosis and bleeding. Significant clinical bleeding was more frequent than symptomatic thrombosis. The cumulative incidence of a bleeding episode was 30.2% at 14 years. The cumulative incidence of a venous or arterial thrombosis at 14 years was 11.8% and 4.1%, respectively. The analysis of competing factors for venous thrombosis revealed extensive chronic graft-versus-host disease to be the only independent prognostic risk factor. By contrast, six factors were associated with an increased risk of bleeding; advanced disease, ablative conditioning regimen, umbilical cord blood transplantation, anticoagulation, acute III-IV graft-versus-host disease, and transplant-associated microangiopathy. The development of thrombosis did not significantly affect overall survival (P=0.856). However, significant clinical bleeding was associated with inferior survival (P<0.001). In allogeneic hematopoietic stem cell transplantation, significant clinical bleeding is more common than thrombotic complications and affects survival.
DescripciónThis is an open-access paper.-- et al.
Versión del editorhttp://dx.doi.org/10.3324/haematol.2012.069559
URIhttp://hdl.handle.net/10261/134376
DOI10.3324/haematol.2012.069559
Identificadoresdoi: 10.3324/haematol.2012.069559
issn: 0390-6078
e-issn: 1592-8721
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