Outcomes of second hematopoietic stem cell transplantation using reduced-intensity conditioning in an outpatient setting
| Autor: | Ernesto Picón-Galindo, David Gómez-Almaguer, José Luis Herrera-Garza, José Carlos Jaime-Pérez |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Neutropenia Transplantation Conditioning medicine.medical_treatment Graft vs Host Disease Hematopoietic stem cell transplantation Disease Disease-Free Survival 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine medicine Outpatient setting Ambulatory Care Humans Cumulative incidence Autografts Survival analysis Retrospective Studies business.industry Hematopoietic Stem Cell Transplantation Myeloid leukemia Hematology General Medicine Middle Aged Allografts Transplantation Survival Rate surgical procedures operative Oncology 030220 oncology & carcinogenesis Reduced Intensity Conditioning Chronic Disease Female business 030215 immunology |
| Zdroj: | Hematological oncologyREFERENCES. 39(1) |
| ISSN: | 1099-1069 |
| Popis: | Relapse and graft failure after autologous (auto) or allogeneic (allo) hematopoietic stem cell transplantation (HSCT) are serious and frequently fatal events. A second HSCT can be a life-saving alternative, however, information on the results of such intervention in an outpatient setting is limited. Outpatient second hematoprogenitors transplant after reduced-intensity conditioning (RIC) at a single academic center was analyzed. Twenty-seven consecutive adults who received an allo-HSCT after an initial auto- or allo-HSCT from 2006 to 2019 were included. Data were compared using the χ2 -test. Survival analysis using Kaplan-Meier and Cox proportional hazard models was performed; cumulative incidence estimation of transplant-related mortality (TRM) was assessed. Hodgkin lymphoma was the most frequent diagnosis for the group with a first auto-HSCT with 5/12 (41.7%) cases, and acute myeloid leukemia for those with a first allo-HSCT with 6/15 (40%). One-year overall survival and disease-free survival (DFS) was 66.7% (95% CI 27.2-88.2) and 59% (95% CI 16-86) for 12 patients with a first auto-HSCT; and for 15 patients with a first allo-HSCT, it was 43.3% (95% CI 17.9-66.5) and 36% (95% CI 13.2-59.9), respectively. Eight (29.6%) patients died of TRM and the cumulative incidence of TRM at 1 year was 22% (95% CI 8.6-39.27). Chronic graft-versus-host disease and late (>10 months) second transplantation were protective factors for longer survival. Neutropenic fever was more common in the group with a first allo-HSCT (p = 0.01). In conclusion, outpatient second allo-HSCT using RIC after auto- or allografting failure or relapse is feasible and offers a reasonable alternative for patients with severe life-threatening hematological diseases. |
| Databáze: | OpenAIRE |
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