Hematolojik malignite hastalarında hiperbarik oksijen tedavisinin klinik seyri ve güvenliği: retrospektif bir analiz

Abstract

Amaç: Yoğun tedavi alan hematolojik maligniteli hastalarda hemorajik sistit, avasküler nekroz (AVN) ve yara iyileşmesinde bozulma gibi tedaviye bağlı komplikasyon riski yüksektir. Bu çalışma, bu kırılgan hasta grubunda destekleyici bir tedavi seçeneği olarak hiperbarik oksijen tedavisinin (HBOT) güvenliğini ve klinik etkinliğini değerlendirmeyi amaçlamaktadır. Yöntem: Bu retrospektif kohort çalışmada, 2017–2023 yılları arasında üçüncü basamak bir hiperbarik tıp merkezinde HBOT uygulanan hematolojik maligniteli 20 hasta değerlendirildi. Demografik veriler, HBOT endikasyonları, komplikasyonlar, klinik sonuçlar ve mortalite analiz edildi. HBOT, monoplace veya multiplace odalarda 2.4 ATA basınçta uygulandı. Bulgular: HBOT endikasyonları arasında AVN (%35), hemorajik sistit (%30) ve yara iyileşmesinde bozulma (%25) yer aldı. Medyan takip süresi 595 gündü. HBOT’ye bağlı ciddi bir komplikasyon gözlenmedi; yalnızca bir hafif barotravma vakası bildirildi. HBOT seans sayısı ile mortalite veya nüks arasında istatistiksel olarak anlamlı bir ilişki saptanmadı. Hemorajik sistit ve yara iyileşme sorunları olan hastaların çoğunda klinik iyileşme gözlendi. Sonuç: HBOT, özellikle sıkı enfeksiyon kontrol önlemleri altında uygulandığında, hematolojik maligniteli hastalarda uygulanabilir ve iyi tolere edilen bir destek tedavisi gibi görünmektedir. Bu bulgular, bu hassas hasta grubunda HBOT’nin güvenliği ve etkinliğini doğrulamak amacıyla ileriye dönük çalışmalara ihtiyaç olduğunu göstermektedir.

Keywords

• Hematolojik Neoplaziler
• Destekleyici Tedavi
• İmmünosupresyon
• Yara İyileşmesi

Clinical course and safety of hyperbaric oxygen therapy in patients with hematologic malignancies: a retrospective analysis

Abstract

Aims: Given the high risk of treatment-related complications such as hemorrhagic cystitis (HC), avascular necrosis (AVN), and impaired wound healing in patients with hematologic malignancies undergoing intensive therapies, this study aims to evaluate the safety and clinical effectiveness of hyperbaric oxygen therapy (HBOT) as a supportive treatment modality in this vulnerable patient population. Methods: This retrospective cohort study evaluated 20 patients with hematologic malignancies who received HBOT at a tertiary hyperbaric medicine center between 2017 and 2023. Demographic data, HBOT indications, complications, outcomes, and mortality were analyzed. HBOT was administered at 2.4 ATA in either monoplace or multiplace chambers. Results: HBOT indications included AVN (35%), HC (30%), impaired wound healing (25%), sudden sensorineural hearing loss (5%), and central retinal artery occlusion (5%). Median follow-up was 595 days. No serious HBOT-related complications were reported except for a single case of mild barotrauma. No statistically significant association was found between the number of HBOT sessions and mortality or recurrence. Improvements in clinical outcomes were observed in most patients with HC and wound healing problems. Conclusion: HBOT appears to be a feasible and well-tolerated supportive treatment in patients with hematologic malignancies, particularly when administered under strict infection control measures. These findings support further prospective studies to validate its safety and efficacy in this vulnerable population.

Keywords

• Hyperbaric oxygenation
• hematologic neoplasms
• supportive care
• immunosuppression
• wound healing

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