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

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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.

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Authors and Affiliations

  1. Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho Omiya-ku, Saitama, 330-8503, Japan

    Masaharu Tamaki, Hideki Nakasone, Shunto Kawamura, Junko Takeshita, Nozomu Yoshino, Yukiko Misaki, Kazuki Yoshimura, Ayumi Gomyo, Aki Tanihara, Machiko Kusuda, Yu Akahoshi, Koji Kawamura, Shun-ichi Kimura, Shinichi Kako & Yoshinobu Kanda

Authors
  1. Masaharu Tamaki
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  2. Hideki Nakasone
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  3. Shunto Kawamura
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  4. Junko Takeshita
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  5. Nozomu Yoshino
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  6. Yukiko Misaki
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  7. Kazuki Yoshimura
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  8. Ayumi Gomyo
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  9. Aki Tanihara
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  10. Machiko Kusuda
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  11. Yu Akahoshi
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  12. Koji Kawamura
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  13. Shun-ichi Kimura
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  14. Shinichi Kako
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  15. Yoshinobu Kanda
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Contributions

MT and YK conceived the original idea. MT and HN collected the data. MT and HN performed statistical analysis. MT, HN, and YK analyzed results and interpreted the data. MT wrote the manuscript. The other authors contributed to the critical revision of the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Yoshinobu Kanda.

Ethics declarations

This retrospective study was approved by the Institutional Review Board of Saitama Medical Center, Jichi Medical University, and performed in accordance with the Declaration of Helsinki and its later amendments.

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The authors declare that they have no conflict of interest.

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Tamaki, M., Nakasone, H., Kawamura, S. et al. Impact of blood pressure early after allogeneic hematopoietic cell transplantation on clinical outcomes. Ann Hematol 99, 1369–1376 (2020). https://doi.org/10.1007/s00277-020-03990-y

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  • DOI: https://doi.org/10.1007/s00277-020-03990-y

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