title: Outpatient-based peripheral blood stem cell transplantation for patients with multiple myeloma.
abstract: BACKGROUND
  There is a growing demand for autologous stem cell transplantation (ASCT) in newly diagnosed patients with multiple myeloma (MM), resulting in an increasing pressure on available hospital beds. In addition, more rational utilization of health resources should induce physicians to attempt therapeutic strategies aiming at reduction of costs. The aim of this study was to explore the feasibility and safety of performing ASCT on an outpatient basis, according to an early discharge method.
  
  
  METHODS
  A total of 28 patients affected by MM and in complete or partial remission were selected to receive ASCT on an outpatient basis. In particular, after conditioning with high-dose melphalan and stem cell infusion, patients were programmed to go home and to be rehospitalized in the case of febrile neutropenia or other severe toxicities.
  
  
  RESULTS
  All patients accepted the outpatient-based procedure. Out of 28 patients. 18 (64%) did spend the aplastic phase entirely at home following high-dose chemotherapy and stem cell infusion. A second hospital admission was required in 10 patients (36%). Febrile neutropenia and severe mucositis needing total parenteral nutrition were the most frequent causes of hospitalization. However, there were no documented infections and either fever or mucositis was easily resolved at the time of hematopoietic recovery in all patients.
  
  
  CONCLUSIONS
  ASCT on an outpatient basis is feasible and safe in patients with MM. More than 60% of patients are manageable at home, provided that a caregiver is available.
authors.affiliation: Division of Hematology and Stem Cell Transplantation Unit, Cardarelli Hospital, Naples, Italy. felicettoferrara@katamail.com
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.forename: Salvatore
authors.initials: S
authors.lastname: Palmieri
authors.forename: Assunta
authors.initials: A
authors.lastname: Viola
authors.forename: Carolina
authors.initials: C
authors.lastname: Copia
authors.forename: Ettore Mariano
authors.initials: EM
authors.lastname: Schiavone
authors.forename: Mariacarla
authors.initials: M
authors.lastname: De Simone
authors.forename: Barbara
authors.initials: B
authors.lastname: Pocali
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: D'Amico
authors.forename: Mario
authors.initials: M
authors.lastname: Annunziata
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Mele
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000145:classification / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D010045:Outpatients; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome