Stem Cell Transplantation Unit, Department of Hemato-Oncology and Radiotherapy, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy.
Hematology and Cell Therapy Unit-IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
Biol Blood Marrow Transplant. 2018 Mar;24(3):608-613. doi: 10.1016/j.bbmt.2017.09.021. Epub 2017 Oct 13.
Outpatient autologous stem cell transplantation (ASCT) has proven to be feasible in terms of physical morbidity and mortality outcomes, but little data exist on the impact of this procedure on quality of life (QoL). The purpose of this prospective, observational, longitudinal cohort study was to compare the effects of inpatient (n = 76) and outpatient (n = 64) modes of care on QoL in patients with multiple myeloma who underwent ASCT. Patients were treated according to their preference for the inpatient or outpatient model. QoL was assessed using the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) at baseline (7 days before ASCT; T1) and at days +7 (T2) and +30 (T3) after ASCT. Overall, inpatients achieved higher mean values at each time point (86.05 ± 15.54 at T1, 89.23 ± 19.19 at T2, and 87.96 ± 13.6 at T3) compared with outpatients (85.62 ± 14.51 at T1, 87.42 ± 23.41 at T2, and 83.98 ± 20.2 at T3), although the differences did not reach statistical significance. Inpatients showed higher mean scores than outpatients in physical well-being (7.67 ± 5.7, 15.44 ± 6.34, and 12.96 ± 6.03, respectively, versus 5.89 ± 4.33, 13.92 ± 7.05, and 8.84 ± 6.33, respectively; P < .05). Mean scores on social/family well-being were significantly higher in the outpatient group compared with the inpatient group (22.93 ± 13.29, 21.14 ± 5.31, and 21.64 ± 4.58, respectively, versus 20.59 ± 3.79, 19.52 ± 5.12, and 20.01 ± 3.97, respectively; P = .003). There were no significant between-group differences with respect to functional well-being and emotional status. Among adults at a single institution undergoing ASCT for MM, the use of outpatient care compared with standard transplantation care did not result in improved QoL during transplantation. Further research is needed for replication and to assess longer-term outcomes and implications.
门诊自体干细胞移植（ASCT）已被证明在身体发病率和死亡率方面是可行的，但关于该手术对生活质量（QoL）影响的数据很少。本前瞻性、观察性、纵向队列研究的目的是比较多发性骨髓瘤患者接受 ASCT 时住院（n=76）和门诊（n=64）护理模式对 QoL 的影响。根据患者对住院或门诊模式的偏好进行治疗。使用癌症治疗功能评估-骨髓移植（FACT-BMT）在 ASCT 前 7 天（T1）和 ASCT 后+7 天（T2）和+30 天（T3）评估 QoL。总体而言，与门诊患者相比，住院患者在每个时间点的平均得分更高（T1 时为 86.05±15.54，T2 时为 89.23±19.19，T3 时为 87.96±13.6），而门诊患者（T1 时为 85.62±14.51，T2 时为 87.42±23.41，T3 时为 83.98±20.2），尽管差异无统计学意义。与门诊患者相比，住院患者在身体幸福感方面的平均得分更高（分别为 7.67±5.7、15.44±6.34 和 12.96±6.03，而 5.89±4.33、13.92±7.05 和 8.84±6.33，分别为 6.03；P<0.05）。与住院组相比，门诊组的社会/家庭幸福感平均得分显著更高（分别为 22.93±13.29、21.14±5.31 和 21.64±4.58，而 20.59±3.79、19.52±5.12 和 20.01±3.97，分别为 3.97；P=0.003）。在功能幸福感和情绪状态方面，两组之间没有显著差异。在单一机构接受 MM ASCT 的成年人中，与标准移植护理相比，使用门诊护理并未导致移植期间 QoL 改善。需要进一步的研究来复制和评估更长期的结果和影响。
