Autologous hematopoietic progenitor cell transplantation for multiple myeloma through an outpatient program.
BACKGROUND
There are considerable concerns regarding the appropriate use of health care resources to reduce costs and waiting lists associated with autologous hematopoietic progenitor cell transplantation (AHPCT). One of the strategies to reach this goal is outpatient-based (OpB) AHPCT.


METHODS
We reviewed all the reported experiences in this field and illustrated the various models of OpB AHPCT.


CONCLUSIONS
The role of high-dose melphalan (HDM) followed by AHPCT in the treatment of Multiple Myeloma (MM) continues to evolve in the novel agent era and the International Myeloma Working Group recommends that AHPCT should be offered at some point in the course of the treatment program for a medically fit patient. The relatively short neutropenia and the limited extra-marrow toxicity after HDM support the hypothesis that MM patients are the most suitable for outpatient transplant programs. Various models have shown that the procedure is feasible and safe and may highly contribute to shorten waiting lists and to considerably cut health costs, with an improvement of quality of life. Ideal candidates may be those who are asymptomatic and fully active, who have a full-time caregiver and who can reside within easy reach from the transplant center.
Divisione di Ematologia con Trapianto di Midollo Osseo e Terapia Intensiva, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy. maxmartino65@alice.it
Massimo
M
Martino
Mauro
M
Montanari
Benedetto
B
Bruno
Giuseppe
G
Console
Giuseppe
G
Irrera
Giuseppe
G
Messina
Massimo
M
Offidani
Ilaria
I
Scortechini
Tiziana
T
Moscato
Roberta
R
Fedele
Giuseppe
G
Milone
Luca
L
Castagna
Attilio
A
Olivieri
D000553:Ambulatory Care / Q000379:methods* / Q000523:psychology; D002986:Clinical Trials as Topic / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000523:psychology; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010045:Outpatients / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D014182:Transplantation, Autologous / Q000379:methods