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Updated: May 20, 2026
Intrafemoral Injection of Human Hematopoietic Stem and Progenitor Cells into Immunocompromised Mice
Published on: December 8, 2023
Autologous hematopoietic progenitor cell transplantation for multiple myeloma through an outpatient program
Massimo Martino1, Mauro Montanari, Benedetto Bruno
1Divisione di Ematologia con Trapianto di Midollo Osseo e Terapia Intensiva, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy. maxmartino65@alice.it
Insights
Outpatient autologous hematopoietic progenitor cell transplantation (AHPCT) offers a safe and feasible approach to reduce healthcare costs and waiting times. This strategy is particularly suitable for multiple myeloma patients undergoing high-dose melphalan treatment.
Area of Science:
- Hematology
- Oncology
- Transplantation Medicine
Background:
- Concerns exist regarding healthcare resource utilization for autologous hematopoietic progenitor cell transplantation (AHPCT).
- Outpatient-based (OpB) AHPCT is explored as a strategy to mitigate costs and waiting lists.
Purpose of the Study:
- To review and illustrate various models of outpatient-based autologous hematopoietic progenitor cell transplantation (OpB AHPCT).
Main Methods:
- Systematic review of reported experiences with outpatient-based AHPCT.
- Illustration of different models for implementing OpB AHPCT.
Main Results:
- OpB AHPCT models have demonstrated feasibility and safety.
- The procedure shows potential for reducing waiting lists and healthcare costs.
- An improved quality of life is associated with OpB AHPCT.
Conclusions:
- High-dose melphalan (HDM) followed by AHPCT is recommended for medically fit multiple myeloma (MM) patients.
- MM patients are suitable candidates for outpatient programs due to short neutropenia and limited toxicity after HDM.
- Ideal candidates for OpB AHPCT are active, asymptomatic, have a caregiver, and live near the transplant center.
Introduction:
There are considerable concerns regarding the appropriate use of health care resources to reduce costs and waiting lists associated with autologous hematopoietic progenitor cell transplantation (AHPCT). One of the strategies to reach this goal is outpatient-based (OpB) AHPCT.
Areas Covered:
We reviewed all the reported experiences in this field and illustrated the various models of OpB AHPCT.
Expert Opinion:
The role of high-dose melphalan (HDM) followed by AHPCT in the treatment of Multiple Myeloma (MM) continues to evolve in the novel agent era and the International Myeloma Working Group recommends that AHPCT should be offered at some point in the course of the treatment program for a medically fit patient. The relatively short neutropenia and the limited extra-marrow toxicity after HDM support the hypothesis that MM patients are the most suitable for outpatient transplant programs. Various models have shown that the procedure is feasible and safe and may highly contribute to shorten waiting lists and to considerably cut health costs, with an improvement of quality of life. Ideal candidates may be those who are asymptomatic and fully active, who have a full-time caregiver and who can reside within easy reach from the transplant center.
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