Regimen-related toxicities with high-dose therapy followed by hematopoietic cell rescue leads to considerable patient distress, morbidity, and high readmission rates. Palifermin is a recombinant keratinocyte growth factor that is Food and Drug Administration-approved to decrease severe oral mucositis (OM) associated with autologous hematopoietic cell transplantation (ASCT) for hematologic malignancies. We added palifermin as a supportive care measure for patients with lymphoma undergoing ASCT with BEAM conditioning. We compared patients receiving palifermin (n = 35) with historical controls (n = 38) for toxicity and readmission outcomes. The cumulative incidence of OM of any grade was 23% in the palifermin-treated patients and 42% in the control group. Patients receiving palifermin were less likely to be readmitted (57% versus 82%; P = .04), had fewer hospital readmission days (median, 4 days versus 7 days; P < .01), and had fewer total days in the hospital through day +30 after ASCT (median, 12 days versus 15 days; P = .05). Fewer patients in the palifermin group had >20 days in the hospital through day +30 (9% in the palifermin group versus 23% of controls). Adverse events associated with palifermin were mild and transient. The addition of palifermin limits severe regimen-related toxicities and decreases readmissions and duration of hospital stay. This and other measures are needed to identify comprehensive and cost-effective approaches, possibly including palifermin, to prevent severe regimen-related toxicities and decrease health care resource utilization.
Bibliographical noteFunding Information:
Financial disclosure: This work was supported in part by a grant from the National Cancer Institute (P01 CA65493, to C.G.B and R.S). The research reported here was also supported by National Institutes of Health Grant P30 CA77598 using the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center at the University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health (Award UL1TR002494). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
© 2020 The American Society for Transplantation and Cellular Therapy
- Hematopoietic cell transplantation
- Keratinocyte growth factor
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't