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Autologous hematopoietic stem cell transplantation (auto-HCT) is common in patients with Multiple Myeloma (MM). Nina Shah, from the Hematology-Oncology Department, University of California San Francisco, and colleagues, performed a retrospective analysis of hospital charts for patients with MM undergoing auto-HCT. The aim of the study was to evaluate the differences in clinical characteristics and outcomes of inpatient versus outpatient treatment. The analysis considered patients with auto-HCT therapy between January 2008 and December 2012.
The outpatient group had a lower incidence of AEs and better PFS and OS. The authors suggested that these findings can be attributed to the more favorable baseline characteristics of the outpatient group, as they were younger, had a less advanced disease and fewer co-morbidities. Although a high number of outpatients required hospital admission (80%), they had fewer AEs and there was no significant difference between the two groups for treatment-related mortality.
This, therefore, suggests that the outpatient setting for auto-HCT can be carried out safely, with further study required to fully evaluate symptoms and quality of life for patients in this group. It must also be noted that this study was limited to some extent by patient bias, and future comparisons would need to be carried out using patients with more closely related baseline characteristics. However, this provides positive news for patients, for whom outpatient experiences are often viewed more favorably, and hospital trusts, as they would benefit from reduced overall treatment costs. However, patients need to be assessed on an individual basis.
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