New approach of autologous hematopoietic stem cell transplantation: implementation and evaluation of home treatment in Girona

Abstract

Background and objectives: home-based autologous hematopoietic stem cell transplantation (auto-HSCT) has been used as an alternative to conventional hospital treatment in several hospitals outside Girona, demonstrating improvements in quality of life, a reduction in complications and cost savings. The aim of the study is to develop and implement a protocol for auto-HSCT at home in Girona, evaluating its safety and impact on social, clinical and economical outcomes compared to hospital treatment, as it is considered necessary to create a program specifically adapted to the local context and the resources available at Josep Trueta Hospital. Design: this is a unicentric quasi-experimental study that compares the outcomes of patients undergoing the home-based auto-HSCT protocol with those previously achieved by patients who received auto-HSCT while hospitalized at the Josep Trueta Hospital. The statistician will be blind to patient’s group and independent of intervention. Participants: patients at ICO Girona who are indicated for autologous HSCT with domicile in the regions of Gironès or Pla de l'Estany and available caregiver throughout the day, that meet the inclusion criteria. Patients will be excluded if they have comorbidities or inadequate cultural level or language barrier. Methods: 63 patients will undergo the home-based auto-HSCT protocol developed for Josep Trueta Hospital and will be matched 1:1 according to age, sex, and disease with 63 patients who have undergone auto-HSCT at the hospital. The main outcome of the study is the quality of life of patients undergoing an auto-HSCT, which will be measured using the EQ-5D-5L questionnaire from EuroQuol Group. The incidence and severity of complications such as febrile neutropenia or mucositis, as well as economic costs of hospital procedures are secondary outcomes of the study