High-dose chemotherapy and autologous hematopoietic cell transplantation (Auto-HCT) is an established therapy for patients with multiple myeloma and lymphomas. Post-transplant complications during the neutropenia phase include pancytopenia requiring transfusions and G-CSF support, mucositis and infectious complications.

Previously, we have demonstrated that hyperbaric oxygen therapy (HBO) given day 0 prior to transplant reduced erythropoietin (EPO) levels and improved engraftment in umbilical cord blood transplantation. Subsequently, we conducted a pilot trial to study HBO effects EPO levels and engraftment in Auto-HCT setting. Herein, we review HBO effects on Auto-HCT post-transplant complications.

Methods:

Charts of patient who underwent HBO treatment prior to Auto-HCT on our pilot study and matched historic controls were retrospectively reviewed for post-transplant transfusion requirements, G-CSF support, mucositis and infectious complications

Results:

Nineteen patients completed HBO therapy and were compared to 118 patients in our historic cohort. Basic patient characteristics are listed in table-1. Average days of G-CSF use was 6.2 days in our HBO cohort compared to 9.16 days in the historic cohort (P=0.0007). Average number of transfused packed red cells was 2.1 and 2.58 units (P=0.22), while average number of platelet unit transfusions was 2.5 and 3.2 (P=0.17) in the HBO and historic cohorts, respectively. Mucositis incidence was 26.3% in the HBO cohort compared to 59.3% in controls (P=0.008). Similarly, the rate of neutropenic fever was 47% in the HBO cohort vs. 65% in controls (P=0.11). The rate of admissions, on the other hand, was 31.5% in the HBO cohort compared to 23.7% in controls (P=0.31) with an average length of hospital stay of 6.6 days in the HBO cohort compared to 7.68 days in controls (P=0.31).

Conclusions:

HBO therapy prior to Auto-HCT is associated with lower G-CSF use and lower incidence of mucositis in our retrospective study. Prospective studies are needed to determine HBO effects on Auto-HCT post-transplant complications.

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Disclosures

Ganguly:Onyx: Speakers Bureau; Seattle Genetics: Speakers Bureau; Janssen: Research Funding.

Topics:
hematopoietic stem cell transplantation, hyperbaric oxygenation, transplantation, granulocyte colony-stimulating factor, mucositis, recombinant granulocyte colony stimulating factor, blood transfusion, infection as complication of medical care, chemotherapy regimen, erythropoietin

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2016 by The American Society of Hematology
2016
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