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Home-Based Hematopoietic Cell Transplantation in the United States.

Publication ,  Journal Article
Sung, AD; Giri, VK; Tang, H; Nichols, KR; Lew, MV; Bohannon, L; Ren, Y; Jung, S-H; Dalton, T; Bush, A; Van Opstal, J; Artica, A; Messina, J ...
Published in: Transplant Cell Ther
April 2022

Patients undergoing allogeneic (allo) and autologous (auto) hematopoietic cell transplantation (HCT) require extensive hospitalizations or daily clinic visits for the duration of their transplantation. Home HCT, wherein patients live at home and providers make daily trips to the patient's residence to perform assessments and deliver any necessary interventions, may enhance patient quality of life and improve outcomes. We conducted the first study of home HCT in the United States to evaluate this model in the US healthcare setting and to determine the effect on clinical outcomes and quality of life. This case-control study evaluated patients who received home HCT at Duke University in Durham, North Carolina, from November 2012 to March 2018. Each home HCT patient was matched with 2 controls from the same institution who had received standard treatment based on age, disease, and type of transplant for outcomes comparison. Clinical outcomes were abstracted from electronic health records, and quality of life was assessed via Functional Assessment of Cancer Therapy-Bone Marrow Transplant. Clinical outcomes were compared with Student's t-test or Fisher's exact test (continuous variables) or chi-square test (categorical variables). Quality of life scores were compared using the Student t-test. All analyses used a significance threshold of 0.05. Twenty-five patients received home HCT, including 8 allos and 17 autos. Clinical outcomes were not significantly different between the home HCT patients and their matched controls; home HCT patients had decreased incidence of relapse within 1 year of transplantation. Pre-HCT quality of life was well preserved for autologous home HCT patients. This Phase I study demonstrated that home HCT can be successfully implemented in the United States. There was no evidence that home HCT outcomes were inferior to standard-of-care treatment, and patients undergoing autologous home HCT were able to maintain their quality of life. A Phase II randomized trial of home versus standard HCT is currently underway to better compare outcomes and costs.

Duke Scholars

Published In

Transplant Cell Ther

DOI

EISSN

2666-6367

Publication Date

April 2022

Volume

28

Issue

4

Start / End Page

207.e1 / 207.e8

Location

United States

Related Subject Headings

  • United States
  • Transplantation, Autologous
  • Recurrence
  • Quality of Life
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Case-Control Studies
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Sung, A. D., Giri, V. K., Tang, H., Nichols, K. R., Lew, M. V., Bohannon, L., … Chao, N. J. (2022). Home-Based Hematopoietic Cell Transplantation in the United States. Transplant Cell Ther, 28(4), 207.e1-207.e8. https://doi.org/10.1016/j.jtct.2022.01.015
Sung, Anthony D., Vinay K. Giri, Helen Tang, Krista Rowe Nichols, Meagan V. Lew, Lauren Bohannon, Yi Ren, et al. “Home-Based Hematopoietic Cell Transplantation in the United States.Transplant Cell Ther 28, no. 4 (April 2022): 207.e1-207.e8. https://doi.org/10.1016/j.jtct.2022.01.015.
Sung AD, Giri VK, Tang H, Nichols KR, Lew MV, Bohannon L, et al. Home-Based Hematopoietic Cell Transplantation in the United States. Transplant Cell Ther. 2022 Apr;28(4):207.e1-207.e8.
Sung, Anthony D., et al. “Home-Based Hematopoietic Cell Transplantation in the United States.Transplant Cell Ther, vol. 28, no. 4, Apr. 2022, pp. 207.e1-207.e8. Pubmed, doi:10.1016/j.jtct.2022.01.015.
Sung AD, Giri VK, Tang H, Nichols KR, Lew MV, Bohannon L, Ren Y, Jung S-H, Dalton T, Bush A, Van Opstal J, Artica A, Messina J, Shelby R, Frith J, Lassiter M, Burleson J, Leonard K, Potter AS, Choi T, Gasparetto CJ, Horwitz ME, Long GD, Lopez RD, Sarantopoulos S, Chao NJ. Home-Based Hematopoietic Cell Transplantation in the United States. Transplant Cell Ther. 2022 Apr;28(4):207.e1-207.e8.

Published In

Transplant Cell Ther

DOI

EISSN

2666-6367

Publication Date

April 2022

Volume

28

Issue

4

Start / End Page

207.e1 / 207.e8

Location

United States

Related Subject Headings

  • United States
  • Transplantation, Autologous
  • Recurrence
  • Quality of Life
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Case-Control Studies
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences