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Safety and Cost-Effectiveness of Outpatient Autologous Stem Cell Transplantation in Patients with Multiple Myeloma
- Source :
- Biology of Blood and Marrow Transplantation. 19:547-551
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- High-dose chemotherapy with autologous stem cell transplantation (ASCT) remains the standard of care for patients with multiple myeloma. Outpatient ASCT can be an attractive option given wait times and costs associated with inpatient procedures. We initiated an outpatient transplantation protocol in 2006. Patients were treated at a university hospital outpatient clinic that was open 5 days a week. The present study investigated safety and cost-effectiveness of the outpatient program. Ninety-one patients underwent ASCT between 2006 and 2010. The majority of patients (77%) had Durie-Salmon stage III disease; 38% had 1 or more comorbidities. Seventy-six patients (84%) were hospitalized during the first 100 days, mainly for febrile neutropenia (n = 71). Overall survival at day 100 was 100%. No patient was admitted to an intensive care unit. Risk factors for prolonged hospitalization (longer than 7 days) were disease stage IIB or higher and age >60 years. The cost savings was $19,522 (Canadian dollars) per patient compared with inpatient ASCT, for an annual savings of approximately $740,000. In summary, outpatient ASCT performed in a weekday clinic for patients with multiple myeloma appears to be safe and cost-effective, but is associated with a relatively high hospitalization rate.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pediatrics
Neutropenia
Cost effectiveness
Cost-Benefit Analysis
medicine.medical_treatment
Antineoplastic Agents
Hematopoietic stem cell transplantation
Transplantation, Autologous
Clinical research
law.invention
Autologous stem-cell transplantation
law
Outpatients
medicine
Humans
Outpatient clinic
ASCT
Multiple myeloma
Neoplasm Staging
Retrospective Studies
Transplantation
business.industry
Age Factors
Hematopoietic Stem Cell Transplantation
Hematology
Length of Stay
Middle Aged
MM
medicine.disease
Survival Analysis
Intensive care unit
Surgery
Cost benefit
Female
Multiple Myeloma
business
Febrile neutropenia
Subjects
Details
- ISSN :
- 10838791
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Biology of Blood and Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....db5f9717a22c92cf4442fa38f2747cb6