• Ossama M Maher, Jorge G Silva, Winston W Huh, Branko Cuglievan, April DePombo, Partow Kebriaei, Minjeong Park, Diane Liu, Chloe Tillman, Nidale Tarek, Cooper Laurence J N LJN, and Priti Tewari.
• *Division of Pediatrics Departments of ‡Stem Cell Transplantation and Cellular Therapy §Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX †Department of Pediatrics, The National Cancer Institute, Cairo University, Cairo, Egypt.
• J. Pediatr. Hematol. Oncol. 2017 Nov 1; 39 (8): 609-613.

IntroductionHigh rates of patients require readmission to the hospital within 6 months of hematopoietic stem cell transplantation (HSCT). We investigated the relationship between readmission rates and outcomes after HSCT in children, adolescents, and young adults (CAYA).Materials And MethodsA retrospective analysis of patients (26 years or younger) treated with HSCT was conducted.ResultsA chart review of 435 CAYA who underwent HSCT from 2008 to 2015 revealed that 171 patients (39%) had at least 1 hospital readmission within 180 days of transplant; 87% received allogeneic and 13% received autologous HSCT. A total of 312 readmission events were reported. The median follow-up time was 31 months. Documented infection (n=99) and graft-versus-host disease complications (n=60) were the most common causes. Higher than 2 readmission rates were associated with lower overall survival (OS) (P=0.001) and disease-free survival (P<0.001) in patients who received allogeneic HSCT. These findings were not found in the autologous HSCT. In a multivariate analysis of those who received allogeneic HSCT, prior treatment with ≥2 chemotherapy regimens (P=0.03) was independent predictor of lower OS. There were also trends noted toward lower OS for patients with documented infections at index admission or subsequent readmissions (P=0.09).ConclusionsMore than 2 hospital readmissions within 6 months of allogeneic HSCT in CAYA, who are either heavily pretreated or had documented infections at index admission or subsequent readmissions adversely affected the outcomes.

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