Contextual analysis of hematopoietic stem cell transplantation in outpatients.
Camila Caroline Marcolino Soares, Valéria Dantas de Azevedo, Luana Silva Pereira Sátiro and 3 others
PMID 42659490WHAT IT FOUND
Outpatient stem cell transplant was mapped as feasible, with shorter stays, lower costs and fewer infections.
Readmissions, caregiver burden and patient selection remain central. Nurses are described as central to chemotherapy, monitoring, education and care coordination.
Key findings
01The scoping review included 30 studies from 12 countries, with the USA most represented and 2019 the most prominent publication year.
02Mapped studies reported advantages such as shorter hospital stay, early return to family, and reduced exposure to antibiotics and other cytotoxic drugs, and weaknesses such as hospital readmissions and screening based on social criteria.
03In the specific context, mapped studies reported reduced costs, lower infection rates, reduced neutropenic fever, mucositis and positive blood culture results, decreased morbidity and mortality, improved well-being, excellent hematopoietic recovery, and accelerated neutrophil and platelet engraftment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It is a scoping review, so it maps what studies reported rather than proving outpatient HSCT is safe or superior. Many identified studies were unavailable in full, so relevant evidence may be missing. The included studies came from different countries and models, and the review did not synthesize effectiveness or safety as a controlled comparison. The authors reported limited information about evidence levels for infection prevention, survival and quality of life. The authors also reported that regulations and guidelines for outpatient HSCT implementation were not found in the mapped studies. Readmission, caregiver burden and social-criteria patient selection are recurring practical problems in the mapped studies.
Declared interests
The paper states funding from CAPES scholarships. It gives no author conflict-of-interest declaration in the supplied text.
The easy way to misread this
Do not read this as proof that outpatient HSCT is better than inpatient care for your patients. It maps reported advantages and weaknesses across studies, and the review did not test the model or compare outcomes directly.