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A Comparative Assessment of Quality of Life in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation Through an Outpatient and Inpatient Model
Authors:Massimo Martino  Sabino Ciavarella  Simona De Summa  Letteria Russo  Nicola Meliambro  Lucrezia Imbalzano  Giuseppe Alberto Gallo  Tiziana Moscato  Giuseppe Messina  Anna Ferreri  Maria Cuzzola  Giuseppe Irrera  Virginia Naso  Michele Cimminiello  Giuseppe Console  Giacomo Loseto  Stefania Tommasi  Attilio Guarini
Abstract: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?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.
Keywords:ASCT  Multiple myeloma  Quality of life  Outpatient  Inpatient
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