Evaluation of early hospital discharge after allogeneic bone marrow transplantation for chronic myeloid leukemia.
OBJECTIVE
The increasing number of patients waiting for bone marrow transplantation in our service led to the implement of an early hospital discharge program with the intention of reducing the interval between diagnosis and transplantation. In this study we analyzed the results from early discharge, with outpatient care for patients with chronic myeloid leukemia who underwent allogeneic bone marrow transplantation.


METHODS
Retrospective study at the Bone Marrow Transplantation Unit of Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo.


METHODS
We compared clinical outcomes within 100 days post-transplantation, for 51 patients with chronic myeloid leukemia (CML) who received partially outpatient-based allogeneic hematopoietic stem cell transplantation, and the results were compared with a historical control group of 49 patients who received inpatient-based hematopoietic stem cell transplantation.


RESULTS
There were significantly fewer days of hospitalization (p = 0.004), Pseudomonas-positive cultures (p = 0.006) and nausea and vomiting of grade 2-3 (p < 0.001) in the outpatient group. There were no significant differences in mortality between the groups and no deaths occurred within the first 48 days post-transplantation in the outpatient group.


CONCLUSIONS
This partially outpatient-based hematopoietic stem cell transplantation program allowed an increased number of transplantations in our institution, in cases of CML and other diseases, since it reduced the median length of hospital stay without increasing morbidity and mortality.
Nicolau
José Eduardo
JE
Bone Marrow Transplantation Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. jenicolau@uol.com.br
Melo
Leila Maria Magalhães Pessoa de
LM
Sturaro
Daniel
D
Saboya
Rosaura
R
Dulley
Frederico Luiz
FL
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000401:mortality / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D015466:Leukemia, Myeloid, Chronic-Phase / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012189:Retrospective Studies; D016019:Survival Analysis; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000401:mortality; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology