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Bone Marrow Transplant. 2015 Jul;50(7):947-53. doi: 10.1038/bmt.2015.46. Epub 2015 Apr 13.

Safety of outpatient autologous hematopoietic cell transplantation for multiple myeloma and lymphoma.

Author information

1
Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
2
Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
3
Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA.
4
Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, AZ, USA.

Abstract

Autologous hematopoietic cell transplantation (Auto-HCT) is commonly an in-patient procedure. However, Auto-HCT is increasingly being offered on an outpatient basis. To better characterize the safety of outpatient Auto-HCT, we compared the outcome of 230 patients who underwent Auto-HCT on an in-patient vs outpatient basis for myeloma or lymphoma within a single transplant program. All outpatient transplants occurred in a cancer center day hospital. Hematopoietic recovery occurred earlier in the outpatient cohort, with median time to neutrophil recovery of 10 vs 11 days (P<0.001) and median time to platelet recovery of 19 vs 20 days (P=0.053). Fifty-one percent of the outpatient cohort never required admission, with this percentage increasing in later years. Grade 3-4 non-hematologic toxicities occurred in 29% of both cohorts. Non-relapse mortality at 1 year was 0% in the outpatient cohort and 1.5% in the in-patient cohort (P=0.327). Two-year PFS was 62% for outpatient vs 54% for in-patient (P=0.155). One- and two-year OS was 97% and 83% for outpatient vs 91% and 80% for in-patient, respectively (P=0.271). We conclude that, with daily outpatient evaluation and aggressive supportive care, outpatient Auto-HCT can result in excellent outcomes for myeloma and lymphoma patients.

PMID:
25867651
PMCID:
PMC4490016
DOI:
10.1038/bmt.2015.46
[Indexed for MEDLINE]
Free PMC Article

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