title: Safety of outpatient autologous hematopoietic cell transplantation for multiple myeloma and lymphoma.
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.
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: T M
authors: TM
authors: Graff
authors: Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: A K
authors: AK
authors: Singavi
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: W
authors: W
authors: Schmidt
authors: Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: D
authors: D
authors: Eastwood
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: W R
authors: WR
authors: Drobyski
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: M
authors: M
authors: Horowitz
authors: Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, AZ, USA.
authors: J
authors: J
authors: Palmer
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: M
authors: M
authors: Pasquini
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: D J
authors: DJ
authors: Rizzo
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: W
authors: W
authors: Saber
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: P
authors: P
authors: Hari
authors: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors: T S
authors: TS
authors: Fenske
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D008223:Lymphoma / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000601:surgery* / Q000628:therapy; D010045:Outpatients; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous / Q000379:methods*; D055815:Young Adult