Feasibility and Implementation of a Multimodal Supportive Care Program to Improve Outcomes in Older Patients Undergoing Allogeneic Stem Cell Transplantation
| Autor: | Lihui Cao, Joyce Neumann, Laura K. Whited, Haley E. Gale-Capps, Terri Lynn Shigle, Uday R. Popat, Rachel Ombres, An Ngo-Huang, Tacara Soones, Zandra R. Rivera, Hilary Barelas Sullivan, Rhodora C. Fontillas, Brent Braveman, Brittany C. Kurse, Jill K. Ferguson, David Marin, Richard Lindsay, Nicholas A. Szewczyk, Alison M. Gulbis, Elizabeth J. Shpall, Whitney Wallis, Richard E. Champlin, Latoya Adekoya |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Allogeneic transplantation medicine.medical_treatment Psychological intervention MEDLINE Hematopoietic stem cell transplantation Older patients Health care medicine Immunology and Allergy Humans Transplantation Homologous Intensive care medicine Aged Retrospective Studies Transplantation business.industry Hematopoietic Stem Cell Transplantation Cell Biology Hematology surgical procedures operative Molecular Medicine Feasibility Studies Stem cell business Stem Cell Transplantation |
| Zdroj: | Transplantation and cellular therapy. 27(12) |
| ISSN: | 2666-6367 |
| Popis: | Increasingly, patients age ≥65 years are undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT). Although age alone is a well-documented predictor of overall survival (OS) and nonrelapse mortality (NRM), growing evidence suggests that poor functional status and frailty associated with aging may have roles as well. Our goal in the present study was to identify and improve these and other aging-related maladies by developing a multimodal supportive care program for older allo-SCT recipients. We designed and implemented a multimodal supportive care program, Enhanced Recovery in Stem Cell Transplant (ER-SCT), for patients age ≥65 years undergoing allo-SCT. The ER-SCT program consists of evaluation and critical interventions by key health care providers from multiple disciplines starting before hospital admission for transplantation and extending through 100 days post-allo-SCT. We determined the feasibility of implementing this program in a large stem cell transplantation center. After 1 year of ongoing process improvements, multiple evaluations, and enrollment, we found that a dedicated weekly clinic was necessary to coordinate care and evaluate patients early. We successfully enrolled 57 of 64 eligible patients (89%) in the first year. Our data show that a multimodal supportive care program to enhance recovery for older patients undergoing allo-SCT is feasible. © 2021 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. |
| Databáze: | OpenAIRE |
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