scholarly journals Inferior Outcomes for Patients Developing New-Onset Post-Transplant Diabetes Mellitus after Haploidentical Hematopoietic Cell Transplant

2020 ◽  
Vol 26 (3) ◽  
pp. S354-S355
Author(s):  
Brendan L. Mangan ◽  
Dilan A. Patel ◽  
Heidi Chen ◽  
Katie S. Gatwood ◽  
Michael T. Byrne ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Post Transplant ◽  
New Onset

Cutaneous complications in hematopoietic cell transplant recipients: Impact of biopsy on patient management.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7036-7036
Author(s):  
Oana Valeria Paun ◽  
Tycel Jovelle Phillips ◽  
PingFu Fu ◽  
Robert Novoa ◽  
Kord Honda ◽  
...  
Keyword(s):  
Classification Tree ◽  
Regression Tree ◽  
Hematopoietic Cell ◽  
Classification And Regression Tree ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Data Set ◽  
Post Transplant ◽  
Skin Biopsies ◽  
The Impact

7036 Background: Although skin biopsies are recommended for diagnostic purposes in hematopoietic cell transplant (HCT) recipients, their utility in directing management of post transplant cutaneous eruptions remains uncertain. Little evidence was found in support of this procedure either from a diagnostic or prognostic perspective. Methods: We retrospectively evaluated 351 consecutive HCT recipients transplanted at our institution between January 2005 and December 2011; 156 patients underwent 388 cutaneous biopsies. Results: The group that underwent cutaneous biopsy after transplantation and the group that was spared the procedure were homogenous with regards to age and gender. The pre-biopsy diagnosis and final diagnosis differed in 213 episodes (55%) as determined by histologic evaluation. Biopsy results led to a change in therapy in 61 of 388 (16%) biopsied rashes. With regards to therapy changes, 24 of 61 (39%) occurred in response to a clinical diagnosis of GVHD. In this situation the most frequently noted change was augmentation or addition of systemic immuno-suppression (19 of 24). Changes in systemic therapy occurred with similar frequencies with respect to concordance or discordance between clinical and histopathologic diagnosis (p = 0.12). We used classification and regression tree analysis to develop an algorithm to predict the biopsy yield as expressed by change of management. This is a non-parametric decision tree learning technique that produces a classification tree based on a categorical dependent variable, formed by a collection of rules based on variables in the modeling data set. Conclusions: Cutaneous biopsy findings often changed the clinical dermatologic diagnoses of HCT recipients; however, the impact of biopsy results on treatment decisions was less profound; altered diagnoses in patients who underwent biopsy often did not lead to therapy changes. Skin biopsies of post-transplant patients may not be mandatory for either diagnostic or therapeutic reasons, but in carefully chosen circumstances can yield extremely important data. A prospective study should be undertaken in order to evaluate current practice data and to validate our decision making analysis tree.

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