Larsen Kristin, Spencer Horace, Mohan Meera, Bailey Clyde, Hill Kerri, Kottarathara Mathew, Parikh Richa, Hoque Shadiqul, Erra Amani, Mitma Angel A, Mathur Pankaj, Yarlagadda Lakshmi, Gundarlapalli Sravani, Ogunsesan Yetunde, Hussain Munawwar, Thalambedu Nishanth, Sehti Jaskirat, Al Hadidi Samer, Thanendrarajan Sharmilan, Graziutti Monica, Zangari Maurizio, Barlogie Bart, van Rhee Frits, Tricot Guido, Schinke Carolina
Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
J Clin Med. 2022 Mar 16;11(6):1640. doi: 10.3390/jcm11061640.
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) remains the standard of care for multiple myeloma (MM) patients. Although outpatient ASCT has been shown to be safe and feasible, the procedure is overall rare with most patients in the US undergoing inpatient ASCT. Furthermore, hospitalization rates for patients that undergo outpatient ASCT remain high. Adequate markers that predict hospitalization during outpatient ASCT are lacking, yet would be of great clinical value to select patients that are suited to outpatient ASCT. In this study we aimed to elucidate differences between planned outpatient and inpatient ASCT and further evaluated clinical characteristics that are significantly associated with hospitalization during planned outpatient hospitalization. Factors that were significantly associated with a planned inpatient ASCT included an advanced MM disease stage, worse performance status as well as non-Caucasian race, while low albumin levels and female gender were significantly associated with hospitalization during outpatient ASCT. The results of this analysis provide crucial knowledge of factors that are associated with planned inpatient ASCT and hospitalization during outpatient ASCT and could guide the treating physician in decision-making and further facilitate outpatient transplantation.
大剂量化疗后进行自体干细胞移植（ASCT）仍是多发性骨髓瘤（MM）患者的标准治疗方案。尽管门诊ASCT已被证明是安全可行的，但该手术总体上较为罕见，美国大多数患者接受的是住院ASCT。此外，接受门诊ASCT的患者住院率仍然很高。缺乏能够预测门诊ASCT期间住院情况的充分标志物，但这些标志物对于选择适合门诊ASCT的患者具有重要的临床价值。在本研究中，我们旨在阐明计划门诊和住院ASCT之间的差异，并进一步评估与计划门诊住院期间住院显著相关的临床特征。与计划住院ASCT显著相关的因素包括MM疾病晚期、较差的体能状态以及非白种人种族，而低白蛋白水平和女性性别与门诊ASCT期间的住院显著相关。该分析结果提供了与计划住院ASCT和门诊ASCT期间住院相关因素的关键知识，可指导治疗医生进行决策，并进一步促进门诊移植。
