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• W2785388766 abstract "Background: High dose chemotherapy and autologous stem cell transplant (ASCT) is the preferred consolidation strategy in the treatment of eligible patients with multiple myeloma and related plasma cell dyscrasias. Given the high volume of patients, longer wait times and cost of health care, out-patient transplants for multiple myeloma is the standard of care at the Vancouver General Hospital. We present our experience from the last 10 years. Methods: In British Columbia, the Leukemia/Bone Marrow Transplant Program of BC is the sole transplant program serving the province. The program operates in the Vancouver General Hospital. Patients with multiple myeloma, POEMS and amyloid undergoing ASCT from January 2007 to June 2016 June were included in this analysis. The out-patient unit is open 7 days a week including holidays. Patients are seen at least every alternate day and daily if needed. Treatments in the out-patient unit include intravenous fluids, antibiotics and transfusions. There are set febrile neutropenia treatment guidelines and admission criteria in place. We analysed patient characteristics, number of patients requiring admission, duration of admission, 100 day and one year mortality. Results: We analysed 752 cases who underwent high dose chemotherapy and autologous stem cell transplant from Jan 2007 to June 2016. Out of these, 702 were first ASCTs. Median age was 60 years. 729 (97%) had multiple myeloma (MM), 18 (5%) Amyloidosis and 5 (1%) POEMS. 450 (59.8%) were males and 302 (40.2%) were females. 294 patients (39.1%) were ISS I, 246 (32.71%) ISS II and 136 patients (18.8%) were ISS III and the remaining unknown. The median time to transplant from diagnosis was 5 months (Interquartile range-IQR: 4 to 6 months). Majority of the patients received Melphalan 200 mg/m2 as conditioning regimen, 674 (89.6%). 245 (32.5%) patients needed admission and 74 (9.8%) patients were admitted in first 7 days of ASCT. Median duration of admission was 6 days (IQR 3 to 9 days). Median follow up duration was 34 months (IQR 18 to 59 m). Overall survival at 5 years was 61%. Day 100 all-cause mortality rate was .93% and TRM was .4%. At day 100, 4 patients died of progressive disease, 2, due to pneumonia and 1 with cardiac complications. One year all-cause mortality rate was 4.78%. Conclusion: Out-patient ASCT is a safe and feasible treatment strategy with low TRM. However needs a multidisciplinary approach with close follow up and up to a third of patients require admission. Overall resource utilization and costs are significantly lower than inpatient auto-transplantation." @default.
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• W2785388766 date "2018-03-01" @default.
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• W2785388766 title "Outpatient Autologous Stem Cell Transplants for Multiple Myeloma—Analysis of Safety and Outcomes in a Tertiary Care Centre" @default.
• W2785388766 doi "https://doi.org/10.1016/j.bbmt.2017.12.602" @default.
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