Analysis of factors associated with hematopoietic stem-cell retransplantation: a case-control study

Isabelle Campos de Azevedo

Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem, Natal, RN, Brazil.

Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil.

Marcos Antonio Ferreira Júnior

Universidade Federal de Mato Grosso do Sul, Instituto Integrado de Saúde, Campo Grande, MS, Brazil.

Anália Andréia de Araújo Nascimento

Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem, Natal, RN, Brazil.

Allyne Fortes Vitor

Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem, Natal, RN, Brazil.

Elen Ferraz Teston

Universidade Federal de Mato Grosso do Sul, Instituto Integrado de Saúde, Campo Grande, MS, Brazil.

Oleci Pereira Frota

Universidade Federal de Mato Grosso do Sul, Instituto Integrado de Saúde, Campo Grande, MS, Brazil.

Viviane Euzébia Pereira Santos

Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem, Natal, RN, Brazil.

Corresponding author:
Isabelle Campos de Azevedo. E-mail: isabellebr2511@gmail.com

Authors’ contribution

Study concept and design: Isabelle Campos De Azevedo, Marcos Antonio Ferreira Júnior, Allyne Fortes Vitor, Elen Ferraz Teston, Oleci Pereira Frota, Viviane Euzébia Pereira Santos. Obtaining data: Isabelle Campos De Azevedo, Anália Andréia De Araújo Nascimento. Data analysis and interpretation: Isabelle Campos De Azevedo, Marcos Antonio Ferreira Júnior, Anália Andréia De Araújo Nascimento, Oleci Pereira Frota, Viviane Euzébia Pereira Santos. Statistical analysis: Isabelle Campos De Azevedo, Marcos Antonio Ferreira Júnior, Anália Andréia De Araújo Nascimento, Allyne Fortes Vitor, Elen Ferraz Teston. Obtaining financing: Isabelle Campos De Azevedo, Marcos Antonio Ferreira Júnior. Drafting the manuscript: Isabelle Campos De Azevedo, Marcos Antonio Ferreira Júnior, Anália Andréia De Araújo Nascimento, Allyne Fortes Vitor, Elen Ferraz Teston, Oleci Pereira Frota, Viviane Euzébia Pereira Santos. Critical review of the manuscript as to its relevant intellectual content: Isabelle Campos De Azevedo, Marcos Antonio Ferreira Júnior, Allyne Fortes Vitor, Elen Ferraz Teston, Oleci Pereira Frota, Viviane Euzébia Pereira Santos. All authors approved the final version of the text.

Conflict of interest

The authors have declared that there is no conflict of interest.

Variables	Groups				Odds Ratio [95%CI^*]	p ^†
	case (n=28)		control (n=56)
	n	%	n	%
Gender
Male	17	60.71	34	60.71	1.00 [0.39; 2.53]	1.000^‡
Female	11	39.29	22	39.29	1.00 [0.39; 2.53]	1.000^‡
Age range
Up to 35 years old	13	46.43	26	46.43	1.00 [0.40; 2.48]	1.000^‡
Over 35 years old	15	53.57	30	53.57	1.00 [0.40; 2.48]	1.000^‡
Diagnosis
Acute Myeloid Leukemia	8	28.57	16	28.57	--	1.000^‡
Non-Hodgkin’s lymphoma	6	21.43	12	21.43
Multiple Myeloma	5	17.86	10	17.86
Acute Lymphoblastic Leukemia	4	14.29	8	14.29
Aplastic Anemia	3	10.71	6	10.71
Hodgkin’s disease	1	3.57	2	3.57
Chronic myeloid leukemia	1	3.57	2	3.57
HSCT^§ performed
Allogeneic	17	60.71	34	60.71	1.00 [0.39; 2.53]	1.000^‡
Autologous	11	39.29	22	39.29	1.00 [0.39; 2.53]	1.000^‡
GVHD^\|\|
No	24	85.71	55	98.21	9.17 [0.97; 86.38]	0.040^¶
Yes	4	14.29	1	1.79	9.17 [0.97; 86.38]	0.040^¶
Situation with RGH^**
Treatment finished	12	42.86	37	66.07	0.38 [0.15; 0.97]	0.042^‡
Death	16	57.14	19	33.93	0.38 [0.15; 0.97]	0.042^‡
Follow-up until HSCT
Up to 15 days	17	39.53	26	60.47	1.78 [0.71; 4.49]	0.217^‡
More than 15 days	11	26.83	30	73.17	1.78 [0.71; 4.49]	0.217^‡
Total follow-up time by the HSCT^§ service
Up to 21 months	12	28.57	30	71.43	0.65 [0.26; 1.62]	0.355^‡
More than 21 months	16	38.10	26	61.90	0.65 [0.26; 1.62]	0.355^‡
Survival
Up to 17.5 months	13	30.95	29	69.05	0.81 [0.32; 2.00]	0.643^‡
More than 17.5 months	15	35.71	27	64.29	0.81 [0.32; 2.00]	0.643^‡

Variables	Groups				Odds Ratio [95%CI^*]	p ^†
	case (n=28)		control (n=56)
	n	%	n	%
Drugs administered
Ursodeoxycholic acid
Yes	27	96.43	35	62.50	16.12 [2.05-128.12]	0.001^‡
No	1	3.57	21	37.50	16.12 [2.05-128.12]	0.001^‡
Immunosuppressant
Yes	24	85.71	32	57.14	4.50 [1.38-14.69]	0.009^‡
No	4	14.29	24	42.86	4.50 [1.38-14.69]	0.009^‡
Toxicities presented
Genitourinary
Yes	9	32.14	7	12.50	3.32 [1.08; 10.17]	0.031^‡
No	19	67.86	49	87.50	3.32 [1.08; 10.17]	0.031^‡
Hematological
Yes	21	75.00	27	48.21	3.22 [1.18; 8.79]	0.019^‡
No	7	25.00	29	51.79	3.22 [1.18; 8.79]	0.019^‡
Edema
Yes	19	67.86	24	42.86	2.81 [1.08; 7.30]	0.031^‡
No	9	32.14	32	57.14	2.81 [1.08; 7.30]	0.031^‡
Ophthalmological
Yes	8	28.57	7	12.50	2.80 [0.90; 8.75]	0.070^‡
No	20	71.43	49	87.50	2.80 [0.90; 8.75]	0.070^‡
Sepsis
Yes	8	28.57	8	14.29	2.40 [0.79; 7.28]	0.116^‡
No	20	71.43	48	85.71	2.40 [0.79; 7.28]	0.116^‡

Variables		Frequency		Odds Ratio [95%CI^*]	p ^†
Diagnosis
Acute Myeloid Leukemia		24	1^‡	--	1.000^§
Chronic myeloid leukemia		3	1^‡
Acute Lymphoblastic Leukemia		12	1^‡
Non-Hodgkin’s lymphoma		18	1^‡
Hodgkin’s disease		3	1^‡
Multiple Myeloma		15	1^‡
Aplastic Anemia		9	0^\|\|
Toxicities
Hematological	Yes	48	1^‡	3.22 [1.18; 8.79]	0.019^§
Hematological	No	36	0^\|\|
Edema	Yes	43	1^‡	2.81 [1.08; 7.30]	0.031^§
Edema	No	41	0^\|\|
Comorbidity
GVHD^¶	Yes	5	1^‡	9.17 [0.97; 86.38]	0.040^§
GVHD^¶	No	79	0^\|\|
Infections
Genitourinary	Yes	16	1^‡	3.32 [1.08; 10.17]	0.031^§
Genitourinary	No	68	0^\|\|
Sepsis	Yes	16	1^‡	6.03 [1.386-26.205]	0.017^§
Sepsis	No	68	0^\|\|
Medicines used
Vitamins and supplements	Yes	67	1^‡	2.78 [0.72;10.63]	0.124^§
Vitamins and supplements	No	17	0^\|\|
Bile acid	Yes	62	1^‡	24.32 [27.321; 261.608]	0.004^§
Bile acid	No	22	0^\|\|
Antianemic	Yes	35	1^‡	2.60 [1.02; 6.58]	0.042^§
Antianemic	No	49	0^\|\|
Anti-hemorrhagic	Yes	33	1^‡	1.95 [0.77; 4.91]	0.155^§
Anti-hemorrhagic	No	51	0^\|\|
Anticoagulant	Yes	20	1^‡	3.12 [0.91;7.17]	0.046^§
Anticoagulant	No	64	0^\|\|
Loop Diuretic	Yes	55	1^‡	2.56 [0.90;7.29]	0.074^§
Loop Diuretic	No	29	0^\|\|
Antiviral	Yes	79	1^‡	0.164^**	--
Antiviral	No	5	0^\|\|
Immunosuppressant	Yes	56	1^‡	4.50 [1.38;14.69]	0.009^§
Immunosuppressant	No	28	0^\|\|

Brasil