Risk factors and survival impact of readmission after single-unit cord blood transplantation for adults
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Hospital readmissions have been used as a prognostic indicator for patients receiving allogeneic hematopoietic cell transplantation (HCT). However, the impact of readmission during early and mid-phase of cord blood transplantation (CBT) on long-term outcomes has not been fully investigated. We retrospectively analyzed 156 adult patients who received single-unit CBT in our institute. Among this cohort, thirteen patients (8%) were readmitted within 30 days after discharge, and 27 (17%) were readmitted within 90 days after discharge. The most common causes for readmission within 30 and 90 days of discharge were infection, chronic graft-versus-host disease, and relapse. Higher cryopreserved cord blood CD34+ cell count was only significantly associated with lower readmission within 90 days after discharge. The probabilities of overall survival were significantly lower in patients readmitted within 90 days after discharge compared with those who were not readmitted within 90 days after discharge in univariate and multivariate analysis. These data suggest that readmission within 90 days after discharge may have a significant impact on long-term mortality after single-unit CBT.
KeywordsReadmission Discharge Length of hospital stay Cord blood transplantation Infection
The authors thank all of the physicians and staff at the hospital and the cord blood banks in Japan for their help in this study.
Compliance with ethical standards
Conflict of interest
The authors declare no competing financial interests.
- 2.Terakura S, Atsuta Y, Tsukada N, Kobayashi T, Tanaka M, Kanda J, et al. Comparison of outcomes of 8/8 and 7/8 allele-matched unrelated bone marrow transplantation and single-unit cord blood transplantation in adults with acute leukemia. Biol Blood Marrow Transplant. 2016;22(2):330–8.CrossRefGoogle Scholar
- 17.Rauenzahn S, Truong Q, Cumpston A, Goff L, Leadmon S, Evans K, et al. Predictors and impact of thirty-day readmission on patient outcomes and health care costs after reduced-toxicity conditioning allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2014;20(3):415–20.CrossRefGoogle Scholar
- 22.Giralt S, Ballen K, Rizzo D, Bacigalupo A, Horowitz M, Pasquini M, et al. Reduced-intensity conditioning regimen workshop: defining the dose spectrum. Report of a workshop convened by the center for international blood and marrow transplant research. Biol Blood Marrow Transplant. 2009;15(3):367–9.CrossRefGoogle Scholar
- 25.Ballen KK, Joffe S, Brazauskas R, Wang Z, Aljurf MD, Akpek G, et al. Hospital length of stay in the first 100 days after allogeneic hematopoietic cell transplantation for acute leukemia in remission: comparison among alternative graft sources. Biol Blood Marrow Transplant. 2014;20(11):1819–27.CrossRefGoogle Scholar
- 26.Konuma T, Kato S, Oiwa-Monna M, Tanoue S, Ogawa M, Isobe M, et al. Cryopreserved CD34 + cell dose, but not total nucleated cell dose, influences hematopoietic recovery and extensive chronic graft-versus-host disease after single-unit cord blood transplantation in adult patients. Biol Blood Marrow Transplant. 2017;23(7):1142–50.CrossRefGoogle Scholar
- 31.Kanda J, Chiou LW, Szabolcs P, Sempowski GD, Rizzieri DA, Long GD, et al. Immune recovery in adult patients after myeloablative dual umbilical cord blood, matched sibling, and matched unrelated donor hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2012;18(11):1664–76.CrossRefGoogle Scholar