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Hospital length of stay in the first 100 days after allogeneic hematopoietic cell
transplantation for acute leukemia in remission: comparison among alternative
graft sources
#MMPMID25064747
Ballen KK
; Joffe S
; Brazauskas R
; Wang Z
; Aljurf MD
; Akpek G
; Dandoy C
; Frangoul HA
; Freytes CO
; Khera N
; Lazarus HM
; LeMaistre CF
; Mehta P
; Parsons SK
; Szwajcer D
; Ustun C
; Wood WA
; Majhail NS
Biol Blood Marrow Transplant
2014[Nov]; 20
(11
): 1819-27
PMID25064747
show ga
Several studies have shown comparable survival outcomes with different graft
sources, but the relative resource needs of hematopoietic cell transplantation
(HCT) by graft source have not been well studied. We compared total hospital
length of stay in the first 100 days after HCT in 1577 patients with acute
leukemia in remission who underwent HCT with an umbilical cord blood (UCB),
matched unrelated donor (MUD), or mismatched unrelated donor (MMUD) graft between
2008 and 2011. To ensure a relatively homogenous study population, the analysis
was limited to patients with acute myelogenous leukemia and acute lymphoblastic
leukemia in first or second complete remission who underwent HCT in the United
States. To account for early deaths, we compared the number of days alive and out
of the hospital in the first 100 days post-transplantation. For children who
received myeloablative conditioning, the median time alive and out of the
hospital in the first 100 days was 50 days for single UCB recipients, 54 days for
double UCB recipients, and 60 days for MUD bone marrow (BM) recipients. In
multivariate analysis, use of UCB was significantly associated with fewer days
alive and out of the hospital compared with MUD BM. For adults who received
myeloablative conditioning, the median time alive and out of the hospital in
first 100 days was 52 days for single UCB recipients, 55 days for double UCB
recipients, 69 days for MUD BM recipients, 75 days for MUD peripheral blood stem
cell (PBSC) recipients, 63 days for MMUD BM recipients, and 67 days for MMUD PBSC
recipients. In multivariate analysis, UCB and MMUD BM recipients had fewer days
alive and out of the hospital compared with recipients of other graft sources.
For adults who received a reduced-intensity preparative regimen, the median time
alive and out of the hospital during the first 100 days was 65 days for single
UCB recipients, 63 days for double UCB recipients, 79 days for MUD PBSC
recipients, and 79 days for MMUD PBSC recipients. Similar to the other 2 groups,
receipt of UCB was associated with a fewer days alive and out of the hospital. In
conclusion, length of stay in the first 100 days post-transplantation varies by
graft source and is longer for UCB HCT recipients. These data provide insight
into the resource needs of patients who undergo HCT with these various graft
sources.
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