Inpatient vs outpatient autologous hematopoietic stem cell transplantation for multiple myeloma

Abstract

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.

Risk of febrile neutropenia among patients with multiple myeloma or lymphoma who undergo inpatient versus outpatient autologous stem cell transplantation: a systematic review and meta-analysis

“…At this stage, a total of 1690 articles were excluded for one or more of the following reasons: 1) type of article (reviews, commentaries, case reports, and editorials); 2) reports irrelevant to ASCT; 3) reports irrelevant to multiple myeloma or lymphoma; 4) no comparison of the outpatient and inpatient settings; and/or 5) did not report the outcome of interest. Of the remaining 47 articles that underwent a full-length article review, 38 were excluded for reasons similar to the first review round, leaving 9 studies (one prospective cohort study and eight retrospective cohort studies) for inclusion in the meta-analysis [ 23 – 31 ]. The literature review and selection process are illustrated in Fig.…”

“…Patients who underwent an outpatient ASCT had a significantly lower risk of developing febrile neutropenia than patients who were admitted for the ASCT, with a pooled odds ratio (OR) of 0.44 (95% confidence interval [CI]: 0.29–0.65; p < 0.0001; I 2 = 52%; Fig. 2 ) [ 23 – 31 ]. The risk of septicemia was also significantly lower for the outpatients than the inpatients, with a pooled OR of 0.40 (95% CI: 0.16–0.97; p = 0.04; I 2 = 23%; Fig.…”

“…Similarly, though the odds ratio of having a TRM appeared to be lower for the outpatient group, it did not achieve statistical significance (pooled OR 0.37; 95% CI, 0.11–1.31; p = 0.12; I 2 = 0%; Fig. 4b ) [ 23 , 26 , 27 , 29 , 31 ].

Fig.

…”

“…The long-term OS rate was reported by three studies (the 2-year rate by two studies [ 26 , 31 ], and the 3-year rate by one study [ 24 ]). Despite the odds of surviving at 2–3 years being numerically higher for those undergoing an outpatient versus an inpatient ASCT, the difference did not reach statistical significance (pooled OR 1.87; 95% CI, 0.79–4.47; p = 0.16; I 2 = 82%; Fig.…”

“…Despite the odds of surviving at 2–3 years being numerically higher for those undergoing an outpatient versus an inpatient ASCT, the difference did not reach statistical significance (pooled OR 1.87; 95% CI, 0.79–4.47; p = 0.16; I 2 = 82%; Fig. 5 ) [ 24 , 26 , 31 ].

Fig.

…”