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Inpatient vs outpatient autologous hematopoietic stem cell transplantation for multiple myeloma
Author(s) -
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
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12970
Subject(s) - medicine , multiple myeloma , hematopoietic stem cell transplantation , hematopoietic cell , single center , transplantation , retrospective cohort study , autologous stem cell transplantation , comorbidity , adverse effect , surgery , haematopoiesis , stem cell , biology , genetics
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 ( AE s). 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.