Out-patient stem cell transplantation in patients with multiple myeloma in Shariati Hospital

Background and ObjectivesMultiple myeloma (MM) is a clonal disorder of hematopoietic stem cell. We have been doing in-patient stem cell transplant (SCT) in Iran since 1991; however, this is the first time we have decided to embark on out-patient SCT. Materials and MethodsIn this cohort study, the selected Multiple Myeloma patients received outpatient stem cell transplantation. They were then discharged and followed by an out-patient SCT team including a general physician, a staff nurse and a care giver during the neutropenic period. All data were collected and analyzed using ANOVA test, Caplan mayer curve and SPSS 11.5. ResultsForty four patients received in-patient or out-patient autologus SCT. The rates of median hospital stay were 28 (19-54) and 6.5 days (1-8) in in-patient and out-patient groups, respectively. Median home visit by team was 10.5 days. There were not significant differences (p<0.001) between these groups as far as apheresis days, granulocyte colony stimulatig factor (GCSF) dosage as mobilization, number of mono nuclear cell (MNC) or cluster of differentiation (CD)34+ cell parameters are concerned. There was also a significant decrease in total cost of SCT in out-patient group by 70% (p<0.017) including visit cost with 80% decrease (p<0.01), drug cost with 50% (p<0.004), laboratory cost with 70% (p<0.02), and hospital cost with 70% (p<0.04). ConclusionsOur results show that out-patient autolgous SCT in multiple myeloma patients is feasible and its complications are manageable. Significant reduction in cost and bed requirement is also inevitable.