TREATMENT FOR MULTIPLE MYELOMA IN HOSPITAL AT HOME: CLINICAL
CHARACTERISTICS AND PATIENT CARE PATHWAYS
Abstract
AIM To describe the clinical characteristics and the care pathways of
patients with multiple myeloma (MM) benefiting from hospital at home
(HAH) for their parenteral anticancer treatment METHOD A retrospective
scheme conducted in HAH of Assistance-Publique des Hôpitaux de Paris
(APHP). All patients starting bortezomib treatment line in HAH were
included in 2015. Data collection was based on CHIMIO® software and on
medical records. We analyzed the patient’s characteristics, their
pathways, their long-term outcomes. RESULTS Of 536 patients treated for
cancer in HAH, 154 patients received bortezomib. 73,4% patients began
their first line for their symptomatic MM. Mean age was 70,6 years, 27,3
% under 65 years, 53,9% of men, 27,3% living alone, a median
Karnofsky Performans Status of 70. One third of elderly lived alone,
16,1% required domestic help. The median number of courses was 6
(range: 1-14), the mean duration of treatment was 6,6 m (+ 3,5) in HAH.
The median time to next treatment was 17,5 (range:0-50) months. After 24
months of follow-up after the first administration in HAH, 77,9% were
alive. The median overall survival was still not reached at 4 years.
58,8% -mainly the youngest- went back to HAH for the subsequent
treatment. CONCLUSION Patients treated in HAH for MM - regardless of age
and therapeutic goal- were mainly independent, treated from the first
line in a radius close to hospital. The involvement of HAH was achieved
without safety issues nor compromised long-term outcomes. This study
described the real-world patterns of patients benefiting from HAH.