A Comparative Assessment of Quality of Life in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation Through an Outpatient and Inpatient Model

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 < .05). Mean scores on social/family well-being were significantly higher in the outpatient group compared with the inpatient group (22.93 ± 13.29, 21.14 ± 5.31, and 21.64 ± 4.58, respectively, versus 20.59 ± 3.79, 19.52 ± 5.12, and 20.01 ± 3.97, respectively; 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.

An Anecdotal Case Report of Chronic Lymphatic Leukemia with del(11q) Treated with Ibrutinib: Artificial Nourishment and Physical Activity Program

“…The diagnosis and management of CLL impact quality of life (QoL) [37], and also the sedentary lifestyle of the majority of cancer patients play a negative effect on QoL [5,6,[37][38][39][40][41][42] and on their survival [11]. However, randomized studies have shown the substantial improvement in QoL of…”

“…The diagnosis and management of CLL impact quality of life (QoL) [37], and also the sedentary lifestyle of the majority of cancer patients play a negative effect on QoL [5,6,[37][38][39][40][41][42] and on their survival [11]. However, randomized studies have shown the substantial improvement in QoL of cancer patients due to an adequate program of physical activity [23][24][25]34] and impact the cancer survival [7], since it reduces the peak oxygen consumption, improves physical capacity, increases self-esteem, reduces accumulated stress, and promotes relaxation [8,11].…”

“…In cases like this, despite the possibility of an effective therapy being assigned, there is a point of no return where recovery may not be achieved. The recovery of muscle function in cachectic patients is fundamental, particularly in elderly patients who may develop a depressive psychological syndrome, certain they cannot cope the evolution of the disease [5,6]. In these clinical cases, active and passive motor rehabilitation is necessary to maintain a muscle tone to favor an upright position and, whenever possible, walking capacity [7,8].…”

Primary Cutaneous Anaplastic Large Cell Lymphoma (pcALCL) in Elderly, the Importance of a Sport Activity Training

“…PcALCL is a lymphoma with a good prognosis and low mortality, which mainly concerns the elderly. Unfortunately, several patients have had multiple relapses throughout their clinical history, particularly in forms with diffuse skin localization in multiple body districts [42]. The history of these patients is therefore characterized by many therapeutic lines.…”

Post-Transplant Lymphoproliferative Diseases in the Elderly after Cardiac Transplantation: The Diagnostic Role of [18f] FDG-PET With Co-Registered CT and the Effect of Sports Activity Rehabilitation Program

“…Programs vary from a patient to another and consequently, several parameters should be evaluated: the functional state of the various organs, the 4 psychic conditions, the physical-motor skills (strength, flexibility, muscle coordination), the cardiovascular function in stressful conditions, the comorbidities, the associated drug therapy, the social conditions, the habits and feeding capacity [40][41]. All this fundamental in order to organize a network that the patient can constantly follow [42][43][44][45]. Programs include aerobic exercise to increase muscle endurance, exercises to strengthen the extensor muscles of the legs and the upper limbs, useful for doing household chores and other activities of the daily life [46][47][48].…”