Impact of blood pressure early after allogeneic hematopoietic cell transplantation on clinical outcomes

Ann Hematol. 2020 Jun;99(6):1369-1376. doi: 10.1007/s00277-020-03990-y. Epub 2020 Mar 16.

Abstract

Allogeneic hematopoietic transplantation (allo-HCT) is still associated with significant morbidity and mortality, and risk stratification is critical. In this study, we analyzed the relationship between blood pressure control early after allo-HCT and survival outcomes. All patients who survived longer than 28 days after allo-HCT at our center between June 2007 and June 2018 (n = 353) were included, and the average systolic blood pressure (asBP) from 1 to 28 days after allo-HCT was calculated. According to the results of a ROC curve analysis, an asBP of 131 mmHg was defined as a cut-off value between high and low asBP groups. Non-relapse mortality (NRM) and OS were significantly inferior in the high asBP group (2-year-NRM 28.0% vs 11.1%, P < 0.001; 2-year-OS 46.7% vs 65.7%, P = 0.001). In addition, baseline asBP before commencement of the conditioning regimen and elevation of asBP (asBP - baseline asBP) were both associated with inferior NRM. While these results were also observed in the younger patients (≤ 50 years), no relationship was observed in the older patients (> 50 years). High blood pressure within 28 days after allo-HCT was associated with inferior survival outcomes, especially in patients younger than 50 years.

Keywords: Allogeneic transplantation; Blood pressure; Hypertension; Non-relapse mortality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Pressure / physiology*
  • Cohort Studies
  • Female
  • Hematopoietic Stem Cell Transplantation / methods
  • Hematopoietic Stem Cell Transplantation / mortality*
  • Hematopoietic Stem Cell Transplantation / trends*
  • Humans
  • Hypertension / etiology
  • Hypertension / mortality*
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate / trends
  • Transplantation Conditioning / methods
  • Transplantation Conditioning / mortality*
  • Transplantation Conditioning / trends*
  • Transplantation, Homologous / methods
  • Transplantation, Homologous / trends
  • Treatment Outcome
  • Young Adult