Outpatient ASCT for Multiple Myeloma 'Safe and Cost Effective' Despite Frequent Hospitalizations

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(ChemotherapyAdvisor) – Outpatient autologous stem cell transplantation (ASCT) might be a safe alternative to high-dose chemotherapy with ASCT for patients with multiple myeloma, but most patients (78%) are hospitalized for febrile neutropenia within 100 days, cautioned authors of a Canadian study published in the journal Biology of Blood and Marrow Transplantation.

“(O)utpatient ASCT in a week day clinic for patients with multiple myeloma appears to be safe and cost effective but is associated with a relatively high hospitalization rate,” wrote a team of researchers led by senior author Thomas L. Kiss, MD, of the Division of Hemato-Oncology at Maisonneuve-Rosemont Hospital in Québec, Canada.

The team studied 91 patients with multiple myeloma treated with outpatient ASCT during 2006-2010. Most patients (77%) had stage 3 myeloma and more than a third (38%) had at least one comorbidity, the authors noted.

“Overall survival at day 100 was 100%,” they reported. “No patient was admitted to the  Intensive Care Unit. Risk factors for prolonged hospitalizations (more than 7 days) were disease stage 2B or higher and age older than 60 years.”

Hospitalizations were more common but shorter in duration than seen among patients undergoing inpatient ASCT, the authors reported. These shorter stays translated to lower health care costs for the outpatient procedures.

“Despite the emergence of newer and more effective agents to treat multiple myeloma, ASCT will likely remain a standard of care for multiple myeloma for some time either as first or second line treatment,” the authors noted. “Therefore it is important to continue to improve this treatment modality from a medical but also from a socio-economic view.”

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