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

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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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Authors and Affiliations

  1. Department of LABMED, Translational Cell Therapy Research Group (TCR), Karolinska Institutet, Kliniskt Forskningscentrum (KFC), NOVUM Plan 6, Hälsovägen 7-9, 141 57, Huddinge, Sweden

    Olle Ringdén, Behnam Sadeghi, Gianluca Moretti, Sigrun Finnbogadottir, Brita Eriksson, Jonas Mattsson, Britt-Marie Svahn & Mats Remberger

  2. Department of Oncology-Pathology, Karolinska Institutet, Huddinge, Sweden

    Olle Ringdén, Behnam Sadeghi, Gianluca Moretti, Sigrun Finnbogadottir, Brita Eriksson, Jonas Mattsson, Britt-Marie Svahn & Mats Remberger

  3. Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden

    Olle Ringdén, Behnam Sadeghi, Gianluca Moretti, Sigrun Finnbogadottir, Brita Eriksson, Jonas Mattsson, Britt-Marie Svahn & Mats Remberger

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  1. 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

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