Feasibility and Implementation of a Multimodal Supportive Care Program to Improve Outcomes in Older Patients Undergoing Allogeneic Stem Cell Transplantation

•A multidisciplinary supportive care program to enhance recovery in older patients after allogeneic stem cell transplantation is feasible.•A dedicated clinic can improve operational efficiency. Increasingly, patients age ≥65 years are undergoing allogeneic hematopoietic stem cell transplantation (al...

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Published in:	Transplantation and cellular therapy Vol. 27; no. 12; pp. 1008 - 1014
Main Authors:	Szewczyk, Nicholas A., Ngo-Huang, An, Soones, Tacara N., Adekoya, Latoya M., Fontillas, Rhodora C., Ferguson, Jill K., Gale-Capps, Haley E., Kurse, Brittany C., Lindsay, Richard J., Ombres, Rachel, Rivera, Zandra R., Gulbis, Alison M., Neumann, Joyce L., Braveman, Brent H., Marin, David, Shigle, Terri Lynn, Whited, Laura, Wallis, Whitney D., Sullivan, Hilary, Cao, Lihui, Champlin, Richard E., Shpall, Elizabeth, Popat, Uday R.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-12-2021
Subjects:	Aged Allogeneic transplantation Enhanced recovery Feasibility Studies Hematopoietic Stem Cell Transplantation Humans Older patients Retrospective Studies Stem Cell Transplantation Supportive care Transplantation, Homologous Older patients Supportive care Allogeneic transplantation Enhanced recovery
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Summary:	•A multidisciplinary supportive care program to enhance recovery in older patients after allogeneic stem cell transplantation is feasible.•A dedicated clinic can improve operational efficiency. Increasingly, patients age ≥65 years are undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT). Although age alone is a well-documented predictor of overall survival (OS) and nonrelapse mortality (NRM), growing evidence suggests that poor functional status and frailty associated with aging may have roles as well. Our goal in the present study was to identify and improve these and other aging-related maladies by developing a multimodal supportive care program for older allo-SCT recipients. We designed and implemented a multimodal supportive care program, Enhanced Recovery in Stem Cell Transplant (ER-SCT), for patients age ≥65 years undergoing allo-SCT. The ER-SCT program consists of evaluation and critical interventions by key health care providers from multiple disciplines starting before hospital admission for transplantation and extending through 100 days post-allo-SCT. We determined the feasibility of implementing this program in a large stem cell transplantation center. After 1 year of ongoing process improvements, multiple evaluations, and enrollment, we found that a dedicated weekly clinic was necessary to coordinate care and evaluate patients early. We successfully enrolled 57 of 64 eligible patients (89%) in the first year. Our data show that a multimodal supportive care program to enhance recovery for older patients undergoing allo-SCT is feasible. © 2021 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2666-6367 2666-6367
DOI:	10.1016/j.jtct.2021.09.002