Autologous stem cell transplantation in an outpatient basis. Analysis of feasibility in the Hospital Clinic of Barcelona, Spain

Citation
S. Rives et al., Autologous stem cell transplantation in an outpatient basis. Analysis of feasibility in the Hospital Clinic of Barcelona, Spain, MED CLIN, 113(6), 1999, pp. 201-204
Citations number
11
Language
SPAGNOLO
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
MEDICINA CLINICA
ISSN journal
0025-7753 → ACNP
Volume
113
Issue
6
Year of publication
1999
Pages
201 - 204
Database
ISI
SICI code
0025-7753(19990904)113:6<201:ASCTIA>2.0.ZU;2-T
Abstract
BACKGROUND: Autologous stem cell transplantation (ASCT) is increasingly per formed on an outpatient basis. Preliminary results show a significant finan cial saving without modifying the therapeutic results. The aim of this stud y has been to evaluate the feasibility of this procedure in our the Hospita l Clinic of Barcelona, Spain. PATIENTS AND METHODS: All patients in whom an ASCT due to a hematological m alignancy, having a good performance status, a caregiver 24 h per day, a lo dging near to the hospital and an appropriate cultural and social environme nt, were offered an outpatient management starting the day after term cell administration (day +1). RESULTS: During the study period (April, 1997-June, 1998) 64 ASCT were perf ormed. Fifteen patients (23%) were managed on an outpatient basis. The rema ining patients were not included in the study due to patient preference (26 %), medical reasons (22%), distant home (18%) and social problems (9%). Sev en patients (47%) had to be readmitted in the hospital due to fever (n = 4) , nausea (n = 2) or respiratory distress (n = 1). Patients receiving total body radiation (TBI) in the conditioning regimen did not have a higher read mission rate than those conditioned without TBI. The median hospital stay ( since day +1) was 6 (range: 0-22) and 17 (13-117) days for outpatient and i npatients respectively (p = 0.0016). This reduction would imply a saving of 65% in hospitalization charges and of 12% in total charges. All patients h aving elected the outpatient management were very satisfied by having made that choice. CONCLUSION: With an appropriate patient selection, outpatient ASCT is a fea sible method that may improve the quality of life of the patients and can r educe the costs of the procedure.