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Allografting

Is it safe to treat allogeneic stem cell transplant recipients at home during the pancytopenic phase? A pilot trial

Bone Marrow Transplantation volume 26, pages 1057–1060 (2000)Cite this article

Abstract

After myeloablative treatment and allogeneic stem cell transplantation (ASCT), patients are kept isolated in the hospital to prevent infections during neutropenia. To date, 22 patients have been given the choice of being treated at home. Eleven could not be treated at home, and they served as controls. Most had haematological malignancies. The donors were 12 HLA-compatible unrelated, nine HLA-identical siblings and one twin. In the home care group, three developed bacteraemia, compared to nine in the controls (P < 0.01). Patients in the home care group had fewer days of total parenteral nutrition (median 3 vs 24, P < 0.001), required fewer erythrocyte transfusions (median 4 vs 8, P = 0.01), fewer days on i.v. antibiotics (median 6 vs 13 days), and on analgesics (median 0 vs 15) than the controls (P < 0.05). Days with fever, time to engraftment, days with G-CSF and acute GVHD were the same in the two groups. Seven of 11 patients treated at home were readmitted to the ward for a median of 3 (0–7) days, due to fever or lack of a caregiver at home. Days to discharge to the out-patient clinic were faster in the group treated at home (median 20 vs 35 days, P < 0.01). Patients who were treated at home enjoyed being active and taking a walk when they felt like it. This preliminary report suggests that home care after ASCT is not only safe, but superior to isolation in the hospital. Bone Marrow Transplantation (2000) 26, 1057–1060.

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Acknowledgements

We thank the caregivers and the patients. We also thank all nurses and physicians who helped to make this study possible. We thank Inger Hammarberg for secretarial help and Mats Remberger, PhD, for doing the statistics. This trial was supported by grants from the Swedish Cancer Society. Editor Francis and Dr Zoe Walsh are also thanked for checking the language.

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Authors and Affiliations

  1. Centre for Allogeneic Stem cell Transplantation, Karolinska Institutet Huddinge Hospital, Huddinge, Sweden

    B-M Svahn, B Bjurman, J Aschan & O Ringdén

  2. Department of Hospital Control, Karolinska Institutet, Huddinge Hospital, Huddinge, Sweden

    KE Myrbäck

  3. Department of Clinical Immunology, Karolinska Institutet, Huddinge Hospital, Huddinge, Sweden

    O Ringdén

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  1. B-M Svahn
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Svahn, BM., Bjurman, B., Myrbäck, K. et al. Is it safe to treat allogeneic stem cell transplant recipients at home during the pancytopenic phase? A pilot trial. Bone Marrow Transplant 26, 1057–1060 (2000). https://doi.org/10.1038/sj.bmt.1702672

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