Autologous stem cell transplant in 716 patients with multiple myeloma: Low treatment-related mortality, feasibility of outpatient transplant, and effect of a multidisciplinary quality initiative

Morie Gertz, Stephen Maxted Ansell, David M Dingli, Angela Dispenzieri, Francis K. Buadi, Michelle A. Elliott, Dennis A. Gastineau, Suzanne R. Hayman, William Hogan, David J. Inwards, Patrick Bruce Johnston, Shaji K Kumar, Martha Lacy, Nelson Leung, Ivana Micallef, Luis F. Porrata, Barbara A. Schafer, Robert C. Wolf, Mark R Litzow

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Abstract

We report on the feasibility of outpatient transplant in 716 patients undergoing autologous stem cell transplant for multiple myeloma at Mayo Clinic's site in Rochester, MN, from January 1, 2000, through October 31, 2007. We also report on the development and effect of a multidisciplinary quality initiative implemented by the Mayo Clinic Blood and Marrow Transplant Program involving physicians, nurses, pharmacists, dietitians, and financial specialists for outpatient management of patients undergoing stem cell transplant. This approach uses an electronic ordering system for diagnostic tests and chemotherapy to minimize medical errors. Analysis of hospitalization trends since inception of the program showed that 278 (39%) of the 716 patients treated completed the transplant procedure as outpatients. The median duration of hospitalization for all patients was 4 days; age and serum creatinine levels were predictive of the need for and duration of hospitalization. We also assessed recent treatment-related mortality rates during a 33-month period after implementation of the program (between January 1, 2005, and October 1, 2007). The 100-day survival rate was 99.5% for patients with low-risk myeloma (transplant during first plateau; n=201) and 97.2% for patients with high-risk myeloma (refractory, relapsing or second or greater plateau; n=71). The overall 100-day survival rate was 98.9%. Our experience shows that outpatient transplant is feasible for all patients with multiple myeloma and results in shorter hospital stays and low treatment-related mortality rates.

Original languageEnglish (US)
Pages (from-to)1131-1135
Number of pages5
JournalMayo Clinic Proceedings
Volume83
Issue number10
DOIs
StatePublished - 2008

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Multiple Myeloma
Outpatients
Stem Cells
Transplants
Mortality
Hospitalization
Therapeutics
Survival Rate
Medical Errors
Nutritionists
Pharmacists
Routine Diagnostic Tests
Length of Stay
Creatinine
Bone Marrow
Nurses
Physicians
Drug Therapy
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Autologous stem cell transplant in 716 patients with multiple myeloma : Low treatment-related mortality, feasibility of outpatient transplant, and effect of a multidisciplinary quality initiative. / Gertz, Morie; Ansell, Stephen Maxted; Dingli, David M; Dispenzieri, Angela; Buadi, Francis K.; Elliott, Michelle A.; Gastineau, Dennis A.; Hayman, Suzanne R.; Hogan, William; Inwards, David J.; Johnston, Patrick Bruce; Kumar, Shaji K; Lacy, Martha; Leung, Nelson; Micallef, Ivana; Porrata, Luis F.; Schafer, Barbara A.; Wolf, Robert C.; Litzow, Mark R.

In: Mayo Clinic Proceedings, Vol. 83, No. 10, 2008, p. 1131-1135.

Research output: Contribution to journalArticle

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AU - Johnston, Patrick Bruce

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