BACKGROUND: High-dose melphalan with autologous stem cell support improves survival for patients with myeloma. For selected patients, we have been using a protocol of short hospitalization, discharging patients to home with careful outpatient monitoring in the office, which we hypothesized would reduce complications and utilization of inpatient beds. METHODS: We reviewed 301 initial autologous transplants for myeloma, categorized as brief stay (≤ 4 days, 82 patients) or prolonged stay (≥ 5 days, 219 patients). Selection for a brief stay was determined by clinical characteristics, availability of caregivers at home, distance from our medical center, and patient preference. RESULTS: Within the brief stay population, 67% required readmission before day + 100, but this group still had fewer cumulative hospital days (9 vs. 18, P < .0001). There were fewer documented infections among brief stay patients (22% vs. 46% P < .001) and fewer admissions to intensive care units (0% vs. 5.9%, P = .02). The groups had similar rates of bleeding (1.2% vs. 1.4% P = 1.0) and thrombosis (3.7% vs. 4.6% P = 1.0). No patients in the brief stay group died within 100 days, compared with mortality of 1.8% (P = .6) in the prolonged stay group. CONCLUSION: Carefully selected patients receiving an autologous stem cell transplant for treatment of myeloma can be managed with a brief initial hospitalization and outpatient follow-up, with low morbidity and mortality.
BACKGROUND: High-dose melphalan with autologous stem cell support improves survival for patients with myeloma. For selected patients, we have been using a protocol of short hospitalization, discharging patients to home with careful outpatient monitoring in the office, which we hypothesized would reduce complications and utilization of inpatient beds. METHODS: We reviewed 301 initial autologous transplants for myeloma, categorized as brief stay (≤ 4 days, 82 patients) or prolonged stay (≥ 5 days, 219 patients). Selection for a brief stay was determined by clinical characteristics, availability of caregivers at home, distance from our medical center, and patient preference. RESULTS: Within the brief stay population, 67% required readmission before day + 100, but this group still had fewer cumulative hospital days (9 vs. 18, P < .0001). There were fewer documented infections among brief stay patients (22% vs. 46% P < .001) and fewer admissions to intensive care units (0% vs. 5.9%, P = .02). The groups had similar rates of bleeding (1.2% vs. 1.4% P = 1.0) and thrombosis (3.7% vs. 4.6% P = 1.0). No patients in the brief stay group died within 100 days, compared with mortality of 1.8% (P = .6) in the prolonged stay group. CONCLUSION: Carefully selected patients receiving an autologous stem cell transplant for treatment of myeloma can be managed with a brief initial hospitalization and outpatient follow-up, with low morbidity and mortality.
Authors: M Martino; R M Lemoli; C Girmenia; L Castagna; B Bruno; F Cavallo; M Offidani; I Scortechini; M Montanari; G Milone; L Postacchini; A Olivieri Journal: Bone Marrow Transplant Date: 2016-04-04 Impact factor: 5.483
Authors: Katharina Lisenko; Sandra Sauer; Thomas Bruckner; Gerlinde Egerer; Hartmut Goldschmidt; Jens Hillengass; Johann W Schmier; Sofia Shah; Mathias Witzens-Harig; Anthony D Ho; Patrick Wuchter Journal: BMC Cancer Date: 2017-02-22 Impact factor: 4.430
Authors: O Annibali; C Pensieri; V Tomarchio; V Biagioli; M Pennacchini; A Tendas; V Tambone; M C Tirindelli Journal: Int J Hematol Oncol Stem Cell Res Date: 2017-10-01
Authors: Luis-Gerardo Rodríguez-Lobato; Alexandra Martínez-Roca; Sandra Castaño-Díez; Alicia Palomino-Mosquera; Gonzalo Gutiérrez-García; Alexandra Pedraza; María Suárez-Lledó; Montserrat Rovira; Carmen Martínez; Carlos Fernández de Larrea; María-Teresa Cibeira; Laura Rosiñol; Ester Lozano; Pedro Marín; Joan Cid; Miquel Lozano; Ana Belén Moreno-Castaño; Marta Palomo; Maribel Díaz-Ricart; Cristina Gallego; Adelina Hernando; Susana Segura; Enric Carreras; Álvaro Urbano-Ispizua; Joan Bladé; Francesc Fernández-Avilés Journal: PLoS One Date: 2020-11-04 Impact factor: 3.240