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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.

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


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.

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