Stem Cell Transplant Program, Clinical Section, Department of Hemato-oncology and Radiotherapy, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.
CNR-IFC, Rome, Italy.
Clin Lymphoma Myeloma Leuk. 2021 Apr;21(4):e402-e409. doi: 10.1016/j.clml.2020.11.011. Epub 2020 Nov 20.
The application of different models of autologous stem-cell transplantation (ASCT) in multiple myeloma has demonstrated the feasibility and safety of outpatient-based programs of care. Although several systematic reviews have evaluated the burden of caregivers, only a few studies have included outpatient ASCT.
The feelings of lack of family support, daily activities, and general health were compared between caregivers of 2 groups of patients with multiple myeloma who underwent inpatient (n = 71) or outpatient (n = 25) ASCT.
The 3 features did not significantly differ between the 2 study groups at baseline, before, and 3 months after ASCT. Multivariate modeling showed that the baseline values were significantly related to the changes in study outcomes independent of patient and caregiver characteristics. Other correlates were caregivers' work and patient age for impact on daily activities and disease burden across time for impact on general health (all P < .05).
The outpatient model neither improves nor impairs global caregivers' burden compared to standard ASCT care. Further research is needed to confirm this observation and to better assess the burden and quality of life of caregivers and their influence on patient outcomes and quality of life.
不同模式的自体干细胞移植（ASCT）在多发性骨髓瘤中的应用证明了基于门诊的护理计划的可行性和安全性。尽管已经有几项系统评价评估了照顾者的负担，但只有少数研究包括了门诊 ASCT。
比较了接受住院（n=71）或门诊（n=25）ASCT 的两组多发性骨髓瘤患者的照顾者在缺乏家庭支持、日常活动和一般健康方面的感受。
在 ASCT 之前、期间和之后，两组研究对象的这 3 个特征在基线时没有显著差异。多变量建模显示，基线值与研究结果的变化显著相关，独立于患者和照顾者的特征。其他相关因素包括照顾者的工作和患者的年龄，对日常活动的影响和疾病负担对一般健康的影响（均 P<0.05）。
与标准 ASCT 护理相比，门诊模式既没有改善也没有增加全球照顾者的负担。需要进一步的研究来证实这一观察结果，并更好地评估照顾者的负担和生活质量及其对患者结局和生活质量的影响。
