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Outpatient stem cell transplant feasible for multiple myeloma

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – As a treatment for multiple myeloma, autologous stem cell transplantation can be performed on an outpatient basis, resulting in shorter hospital stays and low treatment-related mortality, according to a report in the Mayo Clinic Proceedings for October.

In the study of 716 patients treated at one center from January 2000 to October 2007, nearly 40% of subjects were able to be treated without hospitalization. Older age and higher serum creatinine levels were predictive of requiring hospitalization and longer stays.

“Although outpatient stem cell transplant has been reported previously, our cohort of patients with multiple myeloma undergoing outpatient transplant is, to our knowledge, the largest to date,” Dr. Morie A. Gertz, from the Mayo Clinic in Rochester, Minnesota, and colleagues note.

The researchers credit their success with outpatient stem cell transplant to a quality initiative instituted by the Mayo Clinic Blood and Marrow Transplant Program. The initiative, which involved the efforts of physicians, nurses, dietitians, pharmacists, and financial specialists, incorporated an electronic ordering system for tests and chemotherapy designed to reduce medical errors.

During the study period, 39% of patients completed the transplant procedure on an outpatient basis. The median hospital stay for all patients was 4 days. For patients older than 65 years and those with elevated creatinine levels, however, the median stays were 7 and 9 days, respectively.

The 100-day survival rates for patients with low- and high-risk myeloma were 99.5% and 97.2%, respectively, the report indicates.

Reference:
Mayo Clin Proc 2008;83:1131-1135.