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Outpatient administration of BEAM conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective

High‐dose BEAM chemotherapy (BCNU, etoposide, Ara‐C, and melphalan) followed by autologous hematopoietic stem cell transplantation is frequently used as consolidative therapy for patients with recurrent or refractory Hodgkin or non‐Hodgkin lymphoma. The BEAM regimen has traditionally been administer...

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Autores principales: Reid, Robin M., Baran, Andrea, Friedberg, Jonathan W., Phillips, Gordon L., Liesveld, Jane L., Becker, Michael W., Wedow, Lucy, Barr, Paul M., Milner, Laurie A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5119960/
https://www.ncbi.nlm.nih.gov/pubmed/27699999
http://dx.doi.org/10.1002/cam4.879
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author Reid, Robin M.
Baran, Andrea
Friedberg, Jonathan W.
Phillips, Gordon L.
Liesveld, Jane L.
Becker, Michael W.
Wedow, Lucy
Barr, Paul M.
Milner, Laurie A.
author_facet Reid, Robin M.
Baran, Andrea
Friedberg, Jonathan W.
Phillips, Gordon L.
Liesveld, Jane L.
Becker, Michael W.
Wedow, Lucy
Barr, Paul M.
Milner, Laurie A.
author_sort Reid, Robin M.
collection PubMed
description High‐dose BEAM chemotherapy (BCNU, etoposide, Ara‐C, and melphalan) followed by autologous hematopoietic stem cell transplantation is frequently used as consolidative therapy for patients with recurrent or refractory Hodgkin or non‐Hodgkin lymphoma. The BEAM regimen has traditionally been administered over 6 days in the hospital, with patients remaining hospitalized until hematologic recovery and clinical stability. In an effort to reduce the length of hospitalization for these patients, our institution has transitioned from inpatient (IP) to outpatient (OP) administration of BEAM conditioning. Here, we report the results of an analysis of the feasibility, cost, complications, and outcomes for the initial group of patients who received OP BEAM compared to a prior cohort of patients who received IP BEAM. Patient and disease characteristics were comparable for the two cohorts, as were engraftment kinetics. Length of hospital stay was reduced by 6 days for the OP cohort (P < 0.001), resulting in a cost savings of more than $17,000 per patient. Fewer complications occurred in the OP cohort, including severe enteritis (P = 0.01), organ toxicities (P = 0.01), and infections (P = 0.04). Overall survival rate up to 3 years posttransplant was better for the OP cohort (P = 0.02), likely due to differences in posttransplant therapies. We conclude that OP administration of BEAM conditioning is safe and may offer significant advantages, including decreased length of hospitalization, reduced costs, decreased risks for severe toxicities and infectious complications, and likely improvement in patient satisfaction and quality of life.
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spelling pubmed-51199602016-11-28 Outpatient administration of BEAM conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective Reid, Robin M. Baran, Andrea Friedberg, Jonathan W. Phillips, Gordon L. Liesveld, Jane L. Becker, Michael W. Wedow, Lucy Barr, Paul M. Milner, Laurie A. Cancer Med Clinical Cancer Research High‐dose BEAM chemotherapy (BCNU, etoposide, Ara‐C, and melphalan) followed by autologous hematopoietic stem cell transplantation is frequently used as consolidative therapy for patients with recurrent or refractory Hodgkin or non‐Hodgkin lymphoma. The BEAM regimen has traditionally been administered over 6 days in the hospital, with patients remaining hospitalized until hematologic recovery and clinical stability. In an effort to reduce the length of hospitalization for these patients, our institution has transitioned from inpatient (IP) to outpatient (OP) administration of BEAM conditioning. Here, we report the results of an analysis of the feasibility, cost, complications, and outcomes for the initial group of patients who received OP BEAM compared to a prior cohort of patients who received IP BEAM. Patient and disease characteristics were comparable for the two cohorts, as were engraftment kinetics. Length of hospital stay was reduced by 6 days for the OP cohort (P < 0.001), resulting in a cost savings of more than $17,000 per patient. Fewer complications occurred in the OP cohort, including severe enteritis (P = 0.01), organ toxicities (P = 0.01), and infections (P = 0.04). Overall survival rate up to 3 years posttransplant was better for the OP cohort (P = 0.02), likely due to differences in posttransplant therapies. We conclude that OP administration of BEAM conditioning is safe and may offer significant advantages, including decreased length of hospitalization, reduced costs, decreased risks for severe toxicities and infectious complications, and likely improvement in patient satisfaction and quality of life. John Wiley and Sons Inc. 2016-10-03 /pmc/articles/PMC5119960/ /pubmed/27699999 http://dx.doi.org/10.1002/cam4.879 Text en © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Reid, Robin M.
Baran, Andrea
Friedberg, Jonathan W.
Phillips, Gordon L.
Liesveld, Jane L.
Becker, Michael W.
Wedow, Lucy
Barr, Paul M.
Milner, Laurie A.
Outpatient administration of BEAM conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective
title Outpatient administration of BEAM conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective
title_full Outpatient administration of BEAM conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective
title_fullStr Outpatient administration of BEAM conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective
title_full_unstemmed Outpatient administration of BEAM conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective
title_short Outpatient administration of BEAM conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective
title_sort outpatient administration of beam conditioning prior to autologous stem cell transplantation for lymphoma is safe, feasible, and cost‐effective
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5119960/
https://www.ncbi.nlm.nih.gov/pubmed/27699999
http://dx.doi.org/10.1002/cam4.879
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