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Retrospective Analysis of a Brazilian Patient Cohort That Underwent Allogeneic Hematopoietic Stem Cell Transplantation (ALLO-HSCT) in the Brazilian Unified Health System (SUS)

Speaker(s)

Flora APADS1, Duarte FB2, Silva TMD1, Kim H1
1Novartis Biociências SA, São Paulo, Brazil, 2Universidade Federal do Ceará, Fortaleza, Brazil

OBJECTIVE: To identify clinical experience and characteristics of patients that underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the Brazilian Unified Health System (SUS).

METHODS: A retrospective analysis of allo-HSCT-associated procedures was conducted by data extraction from SUS public database (DATASUS). Anonymized data from patients that underwent HSCT-related procedures between January 2015 and June 2018 were analyzed, considering a follow-up of two years since the first transplantation. During follow-up period, hospitalizations and event management due to HSCT were collected. Results are presented as association between the number of HSCT and post-HSCT events, time of hospitalization, time to events due to HSCT, ICD-10, and death rate.

RESULTS: From 2,373 eligible patients, 80% had at least one post-HSCT event hospitalization. Overall, patients remained hospitalized an average time of 32.5 days due to HSCT, and 88.2 days due to post-HSCT event management. 80.1% of the events happened within the first year after HSCT. Most common ICD-10 associated allo-HSCT were Acute Myeloblastic Leukemia (27.64%) and Acute Lymphoblastic Leukemia (25.45%), followed by D61.3 (7.42%), D61.0 (6.32%), and C92.1 (6.28%). Most frequent ICD-10-related post-HSCT events were unspecified pain (R52.9; 23.57%) and Graft-Versus-Host-Disease (T86.0; 17.02%), followed by B25.8 (16.28%) and J06.9 (16.07%). Death rate was 22%, particularly in female patients of 40-49 years (24.2%) and male patients of 20-29 years (18.2%). 93% of deaths occurred within the first year after HSCT.

CONCLUSION: Patients that underwent allo-HSCT are susceptible to re-hospitalization due to complications caused by the procedure. Post-HSCT patient experience in SUS includes several hospitalizations, and death is an outcome associated with nearly one-quarter of those. DATASUS is highlighted as an important database in SUS, and the combination with other relevant registries, such as the Brazilian Society for Bone Marrow Transplantation (SBTMO), which is validated by the Brazilian Transplants System, may enrich the availability for HSCT information.

Code

SA39

Topic

Study Approaches

Topic Subcategory

Electronic Medical & Health Records, Registries

Disease

Oncology, Rare and Orphan Diseases