Causative factors for prolonged hospitalization beyond the point of engraftment in patients after autologous peripheral blood stem cell transplantation

In order to assess the incidence and analyze reasons which cause prolongati on of hospital stay in patients engrafted after peripheral blood stem cell transplantation (PBSCT), we performed this retrospective analysis. One hund red patients (receiving 123 conditioning regimens) were included in the ana lysis. Criteria for discharge were presence of myeloid engraftment and abse nce of severe concomitant problems. Ninety subjects (73%) were discharged j ust after engraftment was reached on day +12 (10-14), Discharge was delayed in 33 patients (27%) and the mean prolongation was 3 days (1-11), In 31 pa tients (25%) delayed discharge was due to complications: in 14 patients (11 .4%) because of GIT problems, in 16 patients (13%) because of infectious co mplications and in one patient because of cardiotoxicity. A significantly h igher number of infectious complications was found in patients conditioned with BEAM (19.7% vs 4.2%, P < 0.05) while GIT toxicity was the most common reason for discharge delays in patients conditioned with melfalan 200 mg/m( 2) (8.2% vs 14.7%, NS). No risk factors of hospital stay prolongation were determined. We conclude that in spite of rapid engraftment, non-hematologic al toxicities and infections remain important limitations for further reduc tion of the length of patient hospitalization in a significant number of pa tients after PBSCT.