Haematopoietic stem cell transplantation with non-myeloablative conditioning in the outpatient setting: results, complications and admission requirements in a single institution

Søren L Petersen, Hans O Madsen, Lars P Ryder, Arne Svejgaard, Bodil K Jakobsen, Henrik Sengeløv, Carsten Heilmann, Ebbe Dickmeiss, Lars L Vindeløv

Abstract

Thirty patients with haematological malignancies received peripheral blood stem cells from human leucocyte antigen (HLA)-identical sibling donors after non-myeloablative conditioning with fludarabine and total body irradiation. Twenty-seven patients received the transplant as an outpatient procedure. All patients engrafted. The probability of acute graft-versus-host disease (GVHD) grades II-IV and extensive chronic GVHD was 57% and 80%, respectively. Patients alive on day +365 experienced a median of 44 d (range 4-151) of hospitalization during the first year. In the entire cohort, GVHD accounted for 22%, infections for 18%, thrombotic thrombocytopenic purpura (TTP) for 16% and engraftment syndrome for 14% of the time in hospital. The 1-year risk of TTP was 26%. Acute GVHD was a risk factor for the development of TTP (P = 0.008). With a median follow-up of 602 d, the 2-year estimates for overall survival, progression-free survival, non-relapse mortality and relapse related mortality were 68%, 43%, 22% and 13%, respectively. This transplantation regimen is feasible and induces long-term remissions in heavily pretreated patients. The procedure can be performed in the outpatient setting, but complications could result in a substantial number of admissions during the first year.

OriginalsprogEngelsk
TidsskriftBritish Journal of Haematology
Vol/bind125
Udgave nummer2
Sider (fra-til)225-31
Antal sider7
ISSN0007-1048
DOI
StatusUdgivet - apr. 2004
Udgivet eksterntJa

Fingeraftryk

Dyk ned i forskningsemnerne om 'Haematopoietic stem cell transplantation with non-myeloablative conditioning in the outpatient setting: results, complications and admission requirements in a single institution'. Sammen danner de et unikt fingeraftryk.

Citationsformater