Days alive outside hospital and readmissions in patients undergoing allogeneic transplants from identical siblings or alternative donors

Patrizia Chiusolo, Luca Laurenti, Simona Sica, Idanna Innocenti, Francesco Autore, Elisabetta Metafuni, Eleonora Alma, Alessia Di Giovanni, Andrea Bacigalupo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

We have studied the number of days alive outside the Hospital (DAOH) and the number of readmissions within the first 100 days after transplant in 185 patients who received an allogeneic hemopoietic stem cell transplant (HSCT). The donors were matched siblings (SIB; n=61), or alternative donors (ALT; n=124). The median number of DAOH for SIB transplants (78 days, range 21-84) was significantly greater than DAOH for ALT donor grafts (73 days, range 2-87) (p=0.0003). Other positive predictors of DAOH were the use of reduced-intensity regimens (p=0.01), grade 0-I acute graft versus host disease (GvHD) (p=0.0006), and a comorbidity index equal or less than two (p=0.04). Fifty-one patients required readmission (22%), which was predicted by grade II-IV acute GvHD (p=0.009), higher comorbidity index (p=0.06), and ALT donors as compared to SIBS (p=0.08). The CI of readmission was 18% (95%CI 10-31) for SIB and 30% (95%CI 23-39) for ALT donor grafts. The non relapse mortality (NRM) for patients readmitted was 25% (95%CI 15-43%), compared to 5% (95%CI 2-12%) for patients not readmitted (p=0.0001). In a multivariate analysis, readmission was the strongest predictor of non-relapse mortality (NRM) (HR 2.0) (p=0.0006) and survival (HR 3.4) (p<0.0001). In conclusion: ALT donor transplants have lower numbers of DAOH, as compared to SIB grafts, which implies longer stay in hospital and higher costs. Readmission to hospital within 100 days, is predicted by acute GvHD, comorbidity index, donor type, and has a significant strong impact on non-relapse mortality and survival.
Lingua originaleEnglish
pagine (da-a)e2020055-N/A
RivistaMediterranean Journal of Hematology and Infectious Diseases
Volume12
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Allogeneic hemopoietic stem stell transplantation
  • Healthcare
  • Length of stay
  • Personalized medical care
  • Readmission

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