Hospital Length of Stay in the First 100 Days after Allogeneic Hematopoietic Cell Transplantation for Acute Leukemia in Remission: Comparison Among Alternative Graft Sources

Abstract

between UCB and MMUD for bacterial infections (p ¼ .18) nor fungal infections (p ¼ .52); however, UCB recipients had significantly more viral infections compared to MMUD (p <.0001).The rate (infections per patient per year) of CMV reactivation/disease and adenoviral infections was higher in UCB recipients; MMUD had a higher rate of EBV reactivation (Table 2). Infection as a cause of death was similar among the three graft sources at 1 year (41%, 31%, and 38% for UCB, MUD, and MMUD respectively). Overall survival at 1 year was 50% (46 e 55%), 69% (65 e 72%), and 58% (52 e 64%) for UCB, MUD, and MMUD respectively (p <.0001) and this difference was driven by higher treatment related mortality (TRM) as relapse was similar across the groups. The survival was slightly higher with MMUD compared to UCB (p<.04). In conclusion, 1) The incidences of bacterial, fungal, and particularly viral infections are high after alternative donor transplant; 2) Infections are a major cause of death in the first year after alternative donor transplant; 3) The incidence of infection as cause of death was similar among the graft sources; 4) Viral infections are higher in recipients of UCB compared to MMUD. Future directions will focus on preventative techniques and predictors for infection, particularly for viral infections.

Impact of pre‐transplant depression on outcomes of allogeneic and autologous hematopoietic stem cell transplantation

“…We then evaluated the proportion of days alive and out of the hospital. The CIBMTR has used this approach to examine hospital length of stay during first 100 days after allogeneic HCT in previous studies …”

“…Beyond mortality, the effect of pre‐HCT depression on other outcomes, including hospital length of stay and incidence of acute and chronic graft‐versus‐host disease (GVHD), is currently unknown. Hospital length of stay during the first 100 days post‐HCT is an important marker of health care use and has clinical implications for both patients and families . Acute and chronic GVHD are major post‐transplant complications in patients undergoing allogeneic HCT with resulting functional limitations, morbidity, and mortality .…”

“…Hospital length of stay during the first 100 days post-HCT is an important marker of health care use and has clinical implications for both patients and families. 17 Acute and chronic GVHD are major post-transplant complications in patients undergoing allogeneic HCT with resulting functional limitations, morbidity, and mortality. 9,12,13,18,19 Importantly, GVHD can often be prevented and treated with immunosuppressive therapy to ensure adequate disease control.…”

Challenges to the Sustainability of the U.S. Public Cord Blood System

“…This depends on several factors, including disease, conditioning treatment, and factors related to the transplanted unit. 44 …”

Alternative Donor Graft Sources for Adults with Hematologic Malignancies: A Donor for All Patients in 2017!

“…Umbilical cord blood HSCT outcomes were similar to MUD and MMUD HSCT outcomes in most of the studies presented. Hematopoietic and immunologic recovery was significantly longer in the UCB group [40][41][42] compared with other donor groups, increasing Kindwall-Keller, Ballen the length of stay for these patients [44]. These results were consistent despite conditioning regimen, type of hematologic malignancy, or age of the recipients.…”