Martino M, Lemoli R M, Girmenia C, Castagna L, Bruno B, Cavallo F, Offidani M, Scortechini I, Montanari M, Milone G, Postacchini L, Olivieri A
Dipartimento di Onco-Ematologia, Ematologia con Trapianto di Midollo Osseo, Azienda Ospedaliera BMM, Reggio Calabria, Italy.
Cattedra di Ematologia, Dipartimento di Medicina Interna e Specialità Mediche, Università di Genova, Genova, Italy.
Bone Marrow Transplant. 2016 Aug;51(8):1032-40. doi: 10.1038/bmt.2016.79. Epub 2016 Apr 4.
Multiple myeloma (MM) is the leading indication for autologous stem cell transplantation (ASCT) worldwide. The safety and efficacy of reducing hospital stay for MM patients undergoing ASCT have been widely explored, and different outpatient models have been proposed. However, there is no agreement on the criteria for selecting patients eligible for this strategy as well as the standards for their clinical management. On the basis of this rationale, the Italian Group for Stem Cell Transplantation (GITMO) endorsed a project to develop guidelines for the management of outpatient ASCT in MM, using evidence-based knowledge and consensus-formation techniques. An expert panel convened to discuss the currently available data on the practice of outpatient ASCT management and formulated recommendations according to the supporting evidence. Evidence gaps were filled with consensus-based statements. Three main topics were addressed: (1) the identification of criteria for selecting MM patients eligible for outpatient ASCT management; (2) the definition of standard procedures for performing outpatient ASCT (model, supportive care and monitoring during the aplastic phase); (3) the definition of the standard criteria and procedures for re-hospitalization during the aplastic phase at home. Herein, we report the summary and the results of the discussion and the consensus.
多发性骨髓瘤（MM）是全球范围内自体干细胞移植（ASCT）的主要适应症。对于接受ASCT的MM患者缩短住院时间的安全性和有效性已进行了广泛探索，并提出了不同的门诊模式。然而，对于选择适合该策略的患者的标准以及其临床管理标准尚无共识。基于这一基本原理，意大利干细胞移植小组（GITMO）批准了一个项目，以利用循证知识和共识形成技术制定MM门诊ASCT管理指南。一个专家小组召开会议，讨论目前关于门诊ASCT管理实践的可用数据，并根据支持证据制定建议。证据空白用基于共识的声明来填补。涉及三个主要主题：（1）确定适合门诊ASCT管理的MM患者的选择标准；（2）执行门诊ASCT的标准程序的定义（模式、再生障碍期的支持性护理和监测）；（3）在家中再生障碍期重新住院的标准标准和程序的定义。在此，我们报告讨论的总结、结果及共识。
