QUALITY OF LIFE AND CAREGIVER BURDEN IN MULTIPLE MYELOMA AND LYMPHOMA PATIENTS UNDERGOING OUTPATIENT AUTOLOGOUS STEM CELL TRANSPLANTATION VERSUS INPATIENT TRANSPLANTATION
Bibliographic record
Abstract
Introduction: The outpatient setting has now become a standard alternative to the traditional inpatient approach for autologous stem cell transplantation (ASCT) for multiple myeloma and lymphoma. Outpatient ASCT involves family/friends assuming round-the-clock caregiving responsibilities, and though it is perceived as potentially providing superior patient quality of life (QOL), supporting evidence is limited. Furthermore, little is known about caregiver QOL and lost opportunity costs for caregivers (i.e., wages/travel time). Our objectives were to compare QOL of patients, and their caregivers, in the inpatient versus outpatient settings, and to delineate costs associated with caregiving. Methods: Patients completed 4 questionnaires (FACT-BMT, FACT-Fatigue, EQ5D, and distress impact thermometer) at 5 timepoints during their ASCT: D0 (baseline), D+7, D+14, D+28, and D+100. Caregivers completed 3 questionnaires (C-QOLC, distress impact, and financial impact), as well as a caregiver financial burden questionnaire (C-SAFE), at the same timepoints. Results: In total, 52 patients and 51 caregivers were enrolled (21 inpatients/31 outpatients). Patients’ median age was 57 (range: 18-70), and 67% were male. Majority of caregivers were spouses (73%). In the overall patient population, FACT-BMT scores significantly declined at D+7, then increased to above-baseline by D+100, which is indicative of greater QOL. FACT-Fatigue worsened significantly at D+7, then improved to lower than baseline at D+100. Additionally, EQ5D scores (imaginable health status) significantly declined at D+7 and D+14, then increased to above baseline at D+100 (albeit p>0.05). QOL scores were not significantly different when comparing inpatients vs. outpatients, though general trends existed for less deterioration in QOL in inpatients. Caregiver QOL scores were consistently higher for inpatients, though not statistically significant. Average lost opportunity costs for caregivers was $4195 CAD per caregiver. Conclusions: There was significant deterioration of various aspects of QOL in the overall population. Inpatient caregivers report better QOL than outpatients, though sample size limits further analyses. -13.21 (5.59) p=0.014 -9.46 (2.66) p=0.00053 -21.99 (5.53) p=0.00012 11.17 (6.02) p=0.067 -7.76 (6.09) p=0.20 -5.98 (93.07) p=0.053 -13.84 (6.23) p=0.028 12.09 (8.68) p=0.17 3.16 (5.77) p=0.58 -5.43 (2.91) p=0.064 -5.2 (5.91) p=0.38 12.44 (6.3) p=0.051 16.36 (5.92) p=0.0065 6.75 (2.98) p=0.025 1.56 (6.05) p=0.08 21.26 (6.64) p=0.0019 Keywords: autologous stem cell transplantation (ASCT).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".