In 2015, we implemented an at-home allogeneic haematopoietic cell transplant (allo-HCT) program. Between 2015 and 2018, 252 patients underwent allo-HCT; 41 patients underwent allo-HCT in the at-home program (46% myeloablative; 63% unrelated donor; 32% posttransplant cyclophosphamide), and these patients were compared with 39 in-patients; safety, capacity to release beds for other programs, and economic efficiency cost were evaluated. We observed a lower incidence of febrile neutropenia in the at-home group compared with that in the in-patient group (32% versus 90%; p < 0.0001), whereas the incidence of aspergillosis was similar among groups (at-home 1% versus in-patient 3%; p = 0.5). The at-home patients showed a lower incidence of 1-year severe graft-versus-host disease (GVHD; 10% versus 29%; p = 0.03). There were no differences in 1-year transplant-related mortality, relapse, or overall survival among groups. The re-admission rate in the at-home group was 7%. The at-home setting was less expensive (9087 €/transplant), and its implementation increased capacity by 10.5 allo-HCTs/year. Moreover, a chimeric antigen receptor T-cell program could be established without increasing beds. Thus, our at-home allo-HCT program may be a safe modality to reduce febrile neutropenia and acute GVHD, resulting in lower re-admission rates.

2015 年，我们实施了一项家庭异基因造血细胞移植 (allo-HCT) 计划。2015 年至 2018 年间，252 名患者接受了 allo-HCT；41 名患者在家庭计划中接受了 allo-HCT（46% 清髓；63% 无关供者；32% 移植后环磷酰胺），并将这些患者与 39 名住院患者进行比较；评估了安全性、为其他项目释放床的能力和经济效率成本。我们观察到与住院组相比，在家组发热性中性粒细胞减少症的发生率较低（32% 对 90%；p  < 0.0001），而各组间曲霉病的发生率相似（在家为 1%与住院患者 3%；p = 0.5)。居家患者的 1 年严重移植物抗宿主病发生率较低（GVHD；10% 对 29%；p  = 0.03）。各组之间的 1 年移植相关死亡率、复发或总生存率没有差异。在家组的再入院率为7%。家庭环境更便宜（9087 欧元/移植），并且其实施将容量增加了 10.5 个异种 HCT/年。此外，可以在不增加床位的情况下建立嵌合抗原受体 T 细胞程序。因此，我们的家庭 allo-HCT 计划可能是减少发热性中性粒细胞减少症和急性 GVHD 的安全方式，从而降低再入院率。