Impact of waitlist time on post-HSCT survival: a cohort study at a hospital in southern Brazil

Silva, Tatiana Schnorr; Horvath, Jaqueline Driemeyer Correia; Pereira, Mariana Pinto; David, Caroline Nespolo de; Vargas, Dora Fraga; Rigoni, Lisandra Della Costa; Sartor, Ivaine Tais Sauthier; Kern, Luciane Beatriz; Silva, Priscila de Oliveira da; Paz, Alessandra Aparecida; Daudt, Liane Esteves; Astigarraga, Claudia Caceres

doi:10.1016/j.htct.2023.03.021

Tatiana Schnorr Silva ^⁎* Corresponding author at: Responsabilidade Social, Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS), Hospital Moinhos de Vento, Rio Grande do Sul, RS, Brazil. E-mail address:tss261288@gmail.com (T.S. Silva)

conceived the project

participated in all phases of the manuscript preparation

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

https://orcid.org/0000-0001-7353-882X

Jaqueline Driemeyer Correia Horvath

wrote the first draft

conducted the data analyses

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

https://orcid.org/0000-0001-8440-6590

Mariana Pinto Pereira

wrote the first draft

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

https://orcid.org/0000-0003-2583-9323

Caroline Nespolo de David

wrote the first draft

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

https://orcid.org/0000-0002-6196-7501

Dora Fraga Vargas

conceived the project

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

Lisandra Della Costa Rigoni

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

Ivaine Tais Sauthier Sartor

conceived the project

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

Luciane Beatriz Kern

conceived the project

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

https://orcid.org/0000-0001-7521-8256

Priscila de Oliveira da Silva

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

Alessandra Aparecida Paz

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

Liane Esteves Daudt

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (FAMED UFRGS), Porto Alegre, RS, Brazil

https://orcid.org/0000-0001-9495-6932

Claudia Caceres Astigarraga

conceived the project

participated in the data collection

data interpretation

helped write the manuscript

revising the drafts for publication

reviewed the final version of the manuscript

Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (FAMED UFRGS), Porto Alegre, RS, Brazil

* Corresponding author at: Responsabilidade Social, Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS), Hospital Moinhos de Vento, Rio Grande do Sul, RS, Brazil. E-mail address:tss261288@gmail.com (T.S. Silva)

Conflicts of interest

The authors declare no conflicts of interest.

	All patients		Pediatric patients		Adult patients		P Value
Survival (days)	374	[103-1020]	492	[128-1097.5]	270	[84-894.5]	0.061
Time on the waiting list (days)	176.5	[101.75-262.5]	180	[112-276]	170	[96.5-247.5]	0.352
Time from diagnosis to HSCT (months) ¹	19	[10- 43]	20	[12-44.5]	18	[9.5-40]	0.516
Age (years)	18	[1-34]	9	[4-13]	34	[24-47]
Hospitalization (days)	50	[39-73]	57	[44-79.25]	47	[36.5-64]	0.003*
Sex							0.548
Male	142	62.6	71	64.5	71	60.7
Female	85	37.4	39	35.5	76	39.3
Radiotherapy
<4 Gy	28	30.1	14	28.6	14	31.8
>9.9 Gy	65	69.9	35	71.4	30	68.2
Diagnosis							0.001*
Non-malignant
Aplasia	26	11.5	12	10.9	14	12
Genetic disease	11	4.8	11	10	-	-
Hemoglobinopathy	3	1.3	3	2.7	-	-
Primary immunodeficiency	19	8.4	19	17.3	-	-
Malignant
Lymphomas	14	6.2	3	2.7	11	9.4
Acute lymphocytic leukemia	67	29.5	39	35.5	28	23.9
Acute myeloid leucemia	50	22.0	12	10.9	38	32.5
Chronic lymphocytic and myeloid	13	5.7	2	1.8	11	9.4
Leucemia	13	5.7	2	1.8	11	9.4
Primary myelofibrosis	2	0.9	-	-	2	1.7
Myelodysplastic syndrome	22	9.7	9	8.2	13	11.1
Conditioning regimen							0.034*
Non-myeloablative	84	37	77	70	51	43.6
Myeloablative	143	63	33	30	66	56.4
Total-body irradiation							0.288
No	134	59	61	55.5	73	62.4
Yes	93	41	49	44.5	44	37.6
Time on waiting list							0.790
Up to 3 months	58	25.6	25	22.9	33	28.2
3 to 6 months	76	33.5	37	33.9	39	33.3
6 to 12 months	69	30.4	36	33	33	28.2
More than 12 months	23	10.1	11	10.1	12	10.3
Relapse on the waiting list²							0.368
No	136	82.4	54	85.7	81	80.2
Yes	29	17.6	9	14.3	20	19.8
Transplant donor							0.001*
HLA-identical sibling	95	41.9	28	25.5	67	57.3
Haploidentical donor	41	18.1	21	19.1	20	17.1
Matched Unrelated donor	91	40.1	61	55.5	30	25.6
Post-HSCT relapse							0.252
No	185	81.5	93	84.5	92	78.6
Yes	42	18.5	17	15.5	25	21.4
Acute graft-versus-host disease							0.012*
No	89	40.6	54	50.5	35	31.3
Yes	130	59.4	53	49.5	77	68.7
Chronic graft-versus-host disease							0.983
No	154	70.3	74	69.8	80	70.8
Yes	65	29.7	32	30.2	33	29.2

	All patients		Pediatric patients		Adult patients		Adult patients withmalignancies
	P Value	Relative risk	P Value	Relative risk	P Value	Relative risk	P Value	Relative risk
Sex (female)	0.00	1.78	0.00	2.31	0.00	1.82	0.00	1.83
Diagnosis	0.00	1.25	0.00	1.26	0.00	1.23	0.50	1.05
Relapse on the waiting list	0.00	1.58	0.01	1.71	0.01	1.68	0.01	1.66
Conditioning regimen	0.58	1.15	0.01	1.73	0.14	1.63	0.28	1.40
Stem-cell source	0.01	1.42	0.00	3.02	0.00	1.88	0.00	2.11
Radiation dose >9.9 Gy	0.00	1.35	^a		0.09	1.21	^a
Acute graft-versus-host disease	0.00	0.72	0.00	0.56	0.05	1.34	0.09	1.28
Chronic graft-versus-host disease	0.00	0.72	0.02	0.66	0.09	0.77	0.03	0.71
Age	0.06	1.08	0.00	2.17	0.00	0.79	0.00	0.76
Time from diagnosis to HSCT	0.04	1.12	0.00	0.76	0.00	1.50	0.00	1.52
Time on waiting list
≤3 months	0.00		0.00		0.00		0.00
>3 and ≤6 months	0.06	1.43	0.12	1.65	0.00	3.53	0.00	4.41
>6 and ≤12 months	0.00	1.59	0.17	0.74	0.00	5.86	0.00	6.67
>12 months	0.55	1.09	0.05	0.67	0.00	4.24	0.00	4.86

[1] * Corresponding author at: Responsabilidade Social, Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS), Hospital Moinhos de Vento, Rio Grande do Sul, RS, Brazil. E-mail address:tss261288@gmail.com (T.S. Silva)

Brasil

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Impact of waitlist time on post-HSCT survival: a cohort study at a hospital in southern Brazil

Abstract

Introduction

Objective and Methods

Results

Conclusion