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Home care during neutropenia after allogeneic hematopoietic stem cell transplantation in children and adolescents is safe and may be more advantageous than isolation in hospital
Author(s) -
Ringdén Olle,
Remberger Mats,
Törlén Johan,
Engström Mats,
Fjaertoft Gustav,
Mattsson Jonas,
Svahn BrittMarie
Publication year - 2014
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12262
Subject(s) - medicine , neutropenia , hematopoietic stem cell transplantation , transplantation , incidence (geometry) , pediatrics , cumulative incidence , chemotherapy , physics , optics
After ASCT , children are isolated in hospital to prevent neutropenic infections. Patients living within two‐h drive from the hospital were given the option of treatment at home after ASCT . Daily visits by an experienced nurse and phone calls from a physician from the unit were included in the protocol. We compared 29 children and adolescents treated at home with 58 matched hospital controls. The children spent a median time of 13 days at home (range 2–24 days) and 6 (0–35) days in hospital. The cumulative incidence of acute GVHD grades II – IV was 21% in the home‐care children and 39% in the controls (p = 0.1). Chronic GVHD and probability of relapse were similar in the two groups. TRM at five yr was 11% in the home‐care patients and 18% in the controls. Overall survival at three yr was 77% and 62%, respectively (p = 0.33). None of the patients died at home. Median costs were 38 748 euros in the home‐care patients and 49 282 euros in those treated in the hospital (p = 0.2). We conclude that it is safe for children and adolescents to be treated at home during the pancytopenic phase after ASCT .