Impact of using posttransplant high-dose cyclophosphamide (PT-CY) on the length of hospital stay in patients with acute leukemia in complete remission
Using posttransplant high-dose cyclophosphamide (PT-CY) as the graft versus host disease (GvHD) prophylaxis is an important option to prevent the GvHD in patients after allogeneic hematopoietic stem cell transplantation (allo-HCT) with a “high-grade” HLA-disparity (unrelated, haploidentical donor). However, the influence of PT-CY on the length ofhospital stay and the cost of hospitalization still remains unknown. Here we report data about impact of PT-CY on the length of hospital stay in leukemia patients after allo-HSCT from unrelated donor.
Figure 1. The duration of hospitalization for the patients in complete remission of acute leukemia, who underwent allo-HSCT from unrelated donors using PT-CY and without using PT-CY
Patients and methods
We included 39 patients in the complete remission of acute leukemia, whom allo-HSCT was performed from unrelated or mismatched unrelated donors. At the time of analysis, all patients were discharged from the hospital without any signs of GvHD or graft failure. Detailed characteristics of patients are presented in Table 1. To prevent the GvHD all patients recieve: anti-thymocyte globulin (ATG) 40 mg/kg (on days -4 to -1), cyclosporine A (CSA) 3 mg/kg/day (from +5 day), mycophenolate mofetil (MMF) 3000 mg/day (from + 5 day). After performing allo-HSCT from mismatched unrelated donor, the patients were also treated with PT-CY (50 mg/kg on +3, +4 day).
Length of hospital stay for all patients is presented in Figure 1. According to our analysis, length of hospital stay in patients after allo-HSCT with and without PT-CY was 43 days (14 to 126) versus 48 days (32 to 98) accordingly (p=0.48).
Usage of PT-CY on day +3, +4 in prevention of GVHD does not extend the hospitalization period in leukemia patients transplanted in complete remission.
Allogeneic bone marrow transplantation, immunosuppressive therapy, posttransplant high-dose cyclophosphamide, hospital stay, unrelated donor.