Performing allogeneic and autologous hematopoietic SCT in the outpatient setting: effects on infectious complications and early transplant outcomes.
This retrospective single-center study compared the incidence, spectrum and effect of infections in 1045 consecutive allogeneic (allo) and autologous (auto) hematopoietic SCT (HSCT) performed between 1995 and 2006 in the inpatient (IP) or outpatient (OP) setting. We analyzed 374 allo-HSCT (196 IP and 178 OP) and 671 auto-HSCT (163 IP and 508 OP). The incidence of infection was lower both in auto-OP (25% OP vs 33% IP, P=0.042) and allo-OP cohorts (42.7% OP vs 55.6% IP, P=0.012). The mean number of infections per transplant was lower in both auto-OP (0.39 OP vs 0.57 IP, P=0.05) and in allo-OP cohorts (0.78 OP vs 1.09 IP, P=0.018). The 100-day non-relapse mortality (NRM) for OP auto-HSCT was 4.72% and for IP 3.95% (P=0.68). The 100-day NRM for OP allo-HSCT was lower at 14.1% than it was for IP at 22.6% (P=0.041). Time to onset of first infection and spectrum of infections was similar in all groups. We conclude that performing allo- and auto-HSCT in the OP setting results in short-term outcomes, including infections complications that are comparable to the standard IP setting.
McDiarmid
S
S
The University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada. smcdiarmid@toh.on.ca
Hutton
B
B
Atkins
H
H
Bence-Bruckler
I
I
Bredeson
C
C
Sabri
E
E
Huebsch
L
L
D000328:Adult; D002648:Child; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D007239:Infections / Q000209:etiology*; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology; D010045:Outpatients; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome