Back to Hospital after Stem Cell Transplant

Stem cell transplants result in hospital readmissions for most pediatric recipients

(RxWiki News) Stem cell transplants can – and do – save the lives of very sick kids. New research has discovered that the transplant is often just the start of hospital stays for these young patients.

Nearly 70 percent of children who had stem cell transplants returned to the hospital at least once within six months of the procedure, according to a new study.

The youngsters were readmitted mostly for unexplained fevers and infections.

Children who received stem cells from other people were twice as likely to be readmitted as children whose own stem cells were used.

"Don’t ignore your child’s fever. "

Stem cells can turn into any type of cell, from skin cells to liver or lung cells.

Hematopoietic stem cells turn into blood cells that carry oxygen (red blood cells), fight infection (white blood cells) and products that help the blood to clot (platelets).

Hematopoietic stem cell transplants give a sick child (through an IV) a new immune system to replace the one affected with blood cancer.

Leslie E. Lehmann, MD, clinical director of pediatric stem cell transplantation at Dana-Farber/Children's Hospital Cancer Center (DF/CHCC), directed a study to learn what happens to children after they have these operations.

"This is very important information and will allow us to counsel families appropriately, as well as try to devise interventions that reduce the rate of readmissions," Dr. Lehmann said in a press release.

The researchers reviewed the records of 129 children who had stem cell transplants at Dana-Farber/Boston Children's Hospital Cancer Center between 2008 and 2011.

Here’s what happened:

  • 64 percent of the children returned to the hospital at least once within six months of having a stem cell transplant.
  • Children in the study were readmitted up to 11 times during the course of the study, with the mean (average) being 2.4 times.
  • They stayed in the hospital about nine days.
  • Children who received donor cells from someone else (relative or closely matched stranger) were twice as likely to return to the hospital as were kids whose own cells (autologous) were used – 79 percent to 38 percent
  • Fever that had no known source was the most common (39 percent) reason for returning to the hospital.
  • 24 percent of the children had infections and 15 percent had gastrointestinal (gut) problems.

Despite these trips back to the hospital, Dr. Lehmann said that most of the youngsters did very well, and the treatment was successful.

"We hope these findings can eventually lead to identifying a group of low-risk children who could be managed at local hospitals rather than transplant centers, reducing costs and inconvenience to families," Dr. Lehmann said.

Findings from this study are being presented at the 26th annual meeting of the American Society of Pediatric Hematology Oncology. No outside funding was provided and no conflicts of interest were reported.

It should be noted that all research is considered preliminary before it’s published in a peer-reviewed journal.

Review Date: 
April 24, 2013