BACKGROUND: High-dose chemotherapy and autologous hematopoietic stem cell transplantation (auto-HCT) are commonly performed for multiple myeloma (MM) patients and may be as safe in the outpatient setting as in the inpatient setting. METHODS: We performed a single-center retrospective analysis of all MM patients undergoing auto-HCT between January 2008 and December 2012. We categorized patients as outpatient vs inpatient auto-HCT and compared clinical characteristics and outcomes between the groups. RESULTS: One thousand and forty-six patients were included (669 inpatients, 377 outpatients). Patients transplanted as outpatients were significantly younger (58 [34-78] vs 62 [31-82], P < .001) and more likely to have an hematopoietic stem cell comorbidity index (HCT-CI) score <2 (P = .003) and creatinine <2 (P < .001). There were no differences in treatment-related mortality (TRM) but the inpatient group experienced significantly more grade 2-5 (P = .003) and grade 3-5 (P = .003) adverse events (AEs). 2 year progression-free survival (PFS) was significantly longer in the outpatient group (60% vs 50%, HR =HR 0.7, 95% CI 0.6-0.9, P = .005). 2 year OS was also longer in the outpatient group (83% vs 77%, HR 0.6, 95% CI 04-0.9, P = .01). CONCLUSION: Outpatient auto-HCT can be safely performed for selected patients with MM. Differences in outcomes are likely related to baseline clinical characteristics rather than choice of treatment setting.
BACKGROUND: High-dose chemotherapy and autologous hematopoietic stem cell transplantation (auto-HCT) are commonly performed for multiple myeloma (MM) patients and may be as safe in the outpatient setting as in the inpatient setting. METHODS: We performed a single-center retrospective analysis of all MMpatients undergoing auto-HCT between January 2008 and December 2012. We categorized patients as outpatient vs inpatient auto-HCT and compared clinical characteristics and outcomes between the groups. RESULTS: One thousand and forty-six patients were included (669 inpatients, 377 outpatients). Patients transplanted as outpatients were significantly younger (58 [34-78] vs 62 [31-82], P < .001) and more likely to have an hematopoietic stem cell comorbidity index (HCT-CI) score <2 (P = .003) and creatinine <2 (P < .001). There were no differences in treatment-related mortality (TRM) but the inpatient group experienced significantly more grade 2-5 (P = .003) and grade 3-5 (P = .003) adverse events (AEs). 2 year progression-free survival (PFS) was significantly longer in the outpatient group (60% vs 50%, HR =HR 0.7, 95% CI 0.6-0.9, P = .005). 2 year OS was also longer in the outpatient group (83% vs 77%, HR 0.6, 95% CI 04-0.9, P = .01). CONCLUSION:Outpatient auto-HCT can be safely performed for selected patients with MM. Differences in outcomes are likely related to baseline clinical characteristics rather than choice of treatment setting.
Authors: Scott R Goldsmith; Mark A Fiala; Brandon Wang; Mark A Schroeder; Tanya M Wildes; Armin Ghobadi; Keith Stockerl-Goldstein; Ravi Vij Journal: Ann Hematol Date: 2020-03-04 Impact factor: 3.673
Authors: Guilherme H Oliveira; Sadeer G Al-Kindi; Avirup Guha; Amit K Dey; Isaac B Rhea; Marcos J deLima Journal: Bone Marrow Transplant Date: 2020-10-31 Impact factor: 5.483
Authors: Anthony D Sung; Vinay K Giri; Helen Tang; Krista Rowe Nichols; Meagan V Lew; Lauren Bohannon; Yi Ren; Sin-Ho Jung; Tara Dalton; Amy Bush; Jolien Van Opstal; Alexandra Artica; Julia Messina; Rebecca Shelby; Jennifer Frith; Martha Lassiter; Jill Burleson; Kari Leonard; Ashley S Potter; Taewoong Choi; Cristina J Gasparetto; Mitchell E Horwitz; Gwynn D Long; Richard D Lopez; Stefanie Sarantopoulos; Nelson J Chao Journal: Transplant Cell Ther Date: 2022-01-20
Authors: Ignacio Gómez-Centurión; Gillen Oarbeascoa; María Carmen García; María Carmen López Fresneña; María Josefa Martínez Carreño; Vicente Escudero Vilaplana; Eva González-Haba; Rebeca Bailén; Nieves Dorado; Luis Miguel Juárez; Gabriela Rodríguez Macías; Patricia Font López; Cristina Encinas; Mariana Bastos-Oreiro; Javier Anguita; María Sanjurjo; José Luis Díez-Martin; Mi Kwon Journal: Int J Hematol Date: 2021-09-22 Impact factor: 2.490