Outpatient total body irradiation for pediatric patients undergoing stem cell transplantation

R. Dagher, Kent Robertson, K. G. Lucas, D. Emanuel, F. O. Smith

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

We have retrospectively reviewed the ability to safely deliver total body irradiation (TBI) in the outpatient setting in 10 pediatric patients undergoing stem cell transplantation. Patients had a median age of 14 years (range 9-17 years) with diagnoses that included ALL in second remission, AML in second remission, myelodysplastic syndrome, Ewing's sarcoma, and rhabdomyosarcoma. Patients received a total of 1375 cGy or 1440 cGy given in a hyperfractionated schedule (11 or 12 fractions) over a 4-day period. All children were seen in the outpatient clinic daily during TBI and all were housed within a 20 mile radius of our institution during this period. Eight patients achieved good control of nausea and emesis with ondansetron alone while two patients required ondansetron and diphenhydramine. Nine patients received some form of intravenous hydration during this period (hyperalimentation, fluid boluses in clinic, or night-time intravenous fluids). One patient maintained good hydration with oral intake alone. Only one child required admission during this period for persistent nausea and vomiting despite antiemetics and intravenous fluids. A cost approximation suggests that TBI delivered in the outpatient setting resulted in a saving of approximately $2400 per patient. We conclude that TBI administered to children and adolescents in the outpatient setting can be a safe and cost-effective practice.

Original languageEnglish
Pages (from-to)1065-1067
Number of pages3
JournalBone Marrow Transplantation
Volume19
Issue number11
StatePublished - Jun 1 1997

Fingerprint

Whole-Body Irradiation
Stem Cell Transplantation
Outpatients
Pediatrics
Ondansetron
Nausea
Vomiting
Costs and Cost Analysis
Diphenhydramine
Ewing's Sarcoma
Antiemetics
Rhabdomyosarcoma
Myelodysplastic Syndromes
Ambulatory Care Facilities
Appointments and Schedules

Keywords

  • Outpatient
  • Pediatric
  • Total body irradiation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Outpatient total body irradiation for pediatric patients undergoing stem cell transplantation. / Dagher, R.; Robertson, Kent; Lucas, K. G.; Emanuel, D.; Smith, F. O.

In: Bone Marrow Transplantation, Vol. 19, No. 11, 01.06.1997, p. 1065-1067.

Research output: Contribution to journalArticle

Dagher, R. ; Robertson, Kent ; Lucas, K. G. ; Emanuel, D. ; Smith, F. O. / Outpatient total body irradiation for pediatric patients undergoing stem cell transplantation. In: Bone Marrow Transplantation. 1997 ; Vol. 19, No. 11. pp. 1065-1067.
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