¹ A.C.Camargo Câncer Center, São Paulo, Brazil and ² Universidade Nove de Julho – Campus Vergueiro, São Paulo, Brazil
One of the currently effective methods for the treatment of haematological malignancies is autologous (TAUMO) or allogeneic (TALMO) hematopoietic cell transplantation (TALMO), but it is associated with a combination of factors including sepsis, graft versus host disease, and nephrotoxic drugs may result in a study of acute renal injury (AKI). Aims: to evaluate the presence of AKI in patients with lymphomas or leukemia submitted to bone marrow transplantation (BMT).
A retrospective, observational cohort study based on data from 256 hospitalized patients for BMT between 2012-2014 at a cancer hospital in S~ao Paulo / SP, with 79 cases from January / 2013 to October / 2014 being reviewed. Demographic data, length of hospitalization, and associated morbidities were assessed. The presence of AKI was defined as an increase of 0.3 mg / dL at the baseline creatinine level (Cr). Statistical analysis was performed with the aid of SPSS 20.00 and results described in mean, standard deviation and percentages considering significant if P <0.05.
Initial sample of 256 patients comprised 53.9% of men.The majority of patients with lymphoma (67.2%), being non-Hodgkin (NHL) the most frequent (n=90). TAUMO was performed in 61.7% and among the 98 TALMO cases, 65 were related (66.3%). The time of hospitalization was 29 days (IQR = 23-38 days), with a mean of 39.5 (IQR = 33-55.7) for TALMO and 25 days (IQR = 21-29) for TAUMO (p <0.001). 79 patients were analyzed, 59.5 males, aged 43.1 6 14.3 years. Among these 30.4% were NHL, 26.6% acute myeloid leukemia and 24.1% Hodking lymphoma. It was observed that 20.3% were obese and 7.6% hypertensive. The frequency of AKI was 38% (95% CI 27.3 to 49.0), with 31 deaths, with a probability of survival of 81% (CI 95% 72-89.8) in 100 days and 60.8% (95% CI 71.8-59.8) after 3 years of follow-up. Of the 31 cases of deaths, 14 occurred during hospitalization for BMT; 85.7% (n = 12) had AKI and only 2 cases were not related to AKI (p <0.001). life expectancy in relation to patients who resented AKI (p = 0.770).
There was a significant prevalence of AKI in patients with leukemia and lymphoma after BMT, and the occurrence of this complication during hospitalization increased in-hospital mortality. After discharge, in-hospital LRA was not associated with a reduction in life expectancy in these cases.