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Infectious Complications

Performing allogeneic and autologous hematopoietic SCT in the outpatient setting: effects on infectious complications and early transplant outcomes

Bone Marrow Transplantation volume 45, pages 1220–1226 (2010)Cite this article

Abstract

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.

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Acknowledgements

We thank the health-care professionals on 5 West and Medical Day Care unit for their support in developing the outpatient model of care at The Ottawa Hospital; the Lawson Foundation for funding the pilot project; and the patients, families and friends whose generous donations to the Blood and Marrow Transplantation Foundation Fund at The Ottawa Hospital support research and specifically the publication of this paper.

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Authors and Affiliations

  1. The University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada

    S McDiarmid, H Atkins, I Bence-Bruckler & L Huebsch

  2. Ottawa Health Research Institute, Ottawa, Ontario, Canada

    B Hutton & E Sabri

  3. Medical College of Wisconsin, Milwaukee, WI, USA

    C Bredeson

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  1. S McDiarmid
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  2. B Hutton
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  3. H Atkins
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  4. I Bence-Bruckler
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  5. C Bredeson
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  6. E Sabri
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  7. L Huebsch
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Correspondence to S McDiarmid.

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McDiarmid, S., Hutton, B., Atkins, H. et al. Performing allogeneic and autologous hematopoietic SCT in the outpatient setting: effects on infectious complications and early transplant outcomes. Bone Marrow Transplant 45, 1220–1226 (2010). https://doi.org/10.1038/bmt.2009.330

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