Inpatient vs outpatient autologous hematopoietic stem cell transplantation for multiple myeloma. (8th October 2017)

• Record Type: Journal Article
• Authors: Shah, Nina; Cornelison, A. Megan; Saliba, Rima; Ahmed, Sairah; Nieto, Yago L.; Bashir, Qaiser; Parmar, Simrit; Hosing, Chitra; Popat, Uday; Shpall, Elizabeth J.; Champlin, Richard E.; Qazilbash, Muzaffar
• Is Part Of: European journal of haematology. Volume 99:Number 6(2017)
• Page Start: 532
• Page End: 535
• Publication Date: 2017-10-08
• Subjects: multiple myeloma -- outpatient -- stem cell transplantation; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.12970
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: 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.