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Safety and cost-effectiveness of outpatient autologous transplantation for multiple myeloma in Asia: single-center perspective from Singapore

Bone Marrow Transplantation volume 52, pages 1044–1046 (2017)Cite this article

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Since health care in most of the Asian continent is resource-limited, it is pragmatic to explore cost-effective treatment strategies typically in those aspects of health care that require skill, research and state-of-the-art technology. Autologous stem cell transplantation (ACST) is one such treatment modality and multiple myeloma (MM) remains the leading indication for ASCT in western countries.1, 2

Although MM is an incurable disease, ASCT is currently the standard of care for young and relatively healthy, risk-stratified patients as it leads to better outcomes in comparison with conventional chemotherapy alone.2, 3, 4 Asians have historically had a lower incidence than Caucasians with heterogeneous inter-ethnic variability in incidence.5, 6, 7 Many centers around the world offer outpatient transplant option with safe follow-up and comparable outcomes. However, data on health-care economics and safety of ASCT are lacking in the Asian setting, a region where alleviating constraints on chronic bed shortage can have an exponential impact on quality of health care. The objective of this study was to analyze efficacy, cost-effectiveness and safety of outpatient ASCT in comparison with inpatient ASCT in a homogeneous cohort of MM patients in Singapore, a small Asian country with relatively good health-care resources with easy and prompt access to medical care due to its small size and excellent emergency medical services.

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Acknowledgements

We acknowledge the invaluable assistance of Ms Adeline Lin with data collection and Ms Belinda Tan for coordination of stem cell transplantations for our patients.

Author contributions

MBA conceived of the study and wrote the manuscript. DC and MAA co-wrote the manuscript. MLP, LKT and LPK rendered patient care and performed a critical review of the manuscript. WJC provided data, rendered patient care and performed a critical review of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Hematology/Oncology, National University Cancer Institute Singapore (NCIS), Singapore, Singapore

    M B Abid, M L Poon, L K Tan, L P Koh & W J Chng

  2. Department of Hematology, Tan Tock Seng Hospital Singapore, Singapore, Singapore

    D Christopher

  3. Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University, Baltimore, MD, USA

    M A Abid

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  1. M B Abid
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  2. D Christopher
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  3. M A Abid
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  4. M L Poon
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  5. L K Tan
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  6. L P Koh
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  7. W J Chng
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Corresponding authors

Correspondence to M B Abid or W J Chng.

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The authors declare no conflict of interest.

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Abid, M., Christopher, D., Abid, M. et al. Safety and cost-effectiveness of outpatient autologous transplantation for multiple myeloma in Asia: single-center perspective from Singapore. Bone Marrow Transplant 52, 1044–1046 (2017). https://doi.org/10.1038/bmt.2017.77

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