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Long-term outcome in patients treated at home during the pancytopenic phase after allogeneic haematopoietic stem cell transplantation

Abstract

Patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) were given the option to be treated at home during the pancytopenic phase. Daily visits by a nurse and phone calls from a physician from the unit were part of the protocol. During almost two decades, 252 patients with haematological malignancies and non-malignant disorders were included. Median age was 47 (range 0–72) years. Myeloablative conditioning was given to 102 patients and reduced intensity to 150. Donors were matched unrelated (n = 160), HLA-identical siblings (n = 71), or HLA-mismatched (n = 21). Cumulative incidence of acute graft-versus-host disease (GVHD) was 35% and that of chronic GVHD was 46%. Non-relapse mortality was 14% 10 years after HSCT. In patients with haematological malignancies (n = 229), the 10-year probability of relapse was 34%. No patients died at home. Overall survival was 59% and relapse-free survival was 50% after 10 years. We conclude that patients treated at home after HSCT have an encouraging long-term outcome.

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Acknowledgements

We thank Inger Holmström and Gunilla Tillinger for excellent preparation of this manuscript. This study was supported by grants from the Swedish Cancer Society (CAN2013/671), the Swedish Research Council (K2014-64X-05971-34-4), the Children’s Cancer Foundation (PR2013-0045), the Cancer Society in Stockholm (111293), and Karolinska Institutet.

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Correspondence to Olle Ringdén.

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Ringdén, O., Sadeghi, B., Moretti, G. et al. Long-term outcome in patients treated at home during the pancytopenic phase after allogeneic haematopoietic stem cell transplantation. Int J Hematol 107, 478–485 (2018). https://doi.org/10.1007/s12185-017-2363-5

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  • DOI: https://doi.org/10.1007/s12185-017-2363-5

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Home care
  • Neutropenia
  • Graft-versus-host disease