Efficacy and safety of air-flow beds for autologous hematopoietic stem cell transplantation in multiple myeloma: a retrospective cohort study
- 1Department of Hematology, The First Affiliated Hospital of Anhui Medical University , ,
- 2School of Pharmacy, Anhui University of Chinese Medicine , ,
Abstract
Background: Autologous hematopoietic stem cell transplantation (ASCT) is the standard consolidation therapy for multiple myeloma (MM), but its widespread implementation is constrained by the high cost and limited availability of conventional laminar airflow rooms. The air-flow bed, a single-bed unit equipped with high-efficiency particulate air (HEPA) filtration providing class 100 (ISO class 5) air quality, represents a more accessible and cost-effective alternative.
Methods: In this retrospective cohort study, we compared the efficacy, safety, and costs of ASCT performed in air-flow beds (Group A, n=91) versus conventional laminar airflow rooms (Group B, n=60) in 151 MM patients treated between 2022 and 2026. Multivariable regression models were adjusted for potential confounders. Sepsis was analyzed descriptively because of the small number of events. Platelet transfusion requirements were analyzed using negative binomial regression.
Results: Engraftment outcomes were comparable between groups. Group A showed significantly lower rates of mucositis, diarrhea, and nausea/vomiting, and no sepsis events occurred in Group A compared with four cases (6.7%) in Group B. Pathogen detection rate was lower in Group A than in Group B (5.5% vs. 15.0%, P = 0.050). In negative binomial regression, air-flow bed use was independently associated with a lower number of platelet transfusion units (IRR = 0.50, P<0.001). Higher CD34+ cell dose was also independently associated with fewer platelet transfusions (IRR = 0.94 per 1×10 ⁶ /kg increase, P = 0.003). Sepsis occurred exclusively in Group B (4/60, 6.7% vs. 0/91, 0%). With only four events and complete separation between groups, multivariable logistic regression was not statistically reliable. This finding is therefore reported descriptively and no adjusted effect estimate is presented. Median total costs were significantly lower in Group A (¥121,738 [approximately $16,908] vs. ¥137,506 [approximately $19,098], P = 0.0002). No transplant-related mortality occurred in Group A, whereas one patient (1.7%) in Group B died.
Conclusion: These findings suggest that air-flow beds may represent a safe, effective, and economically viable alternative to conventional laminar airflow rooms for ASCT in MM. Because protective environment and transplant era were strongly intertwined, these observational associations should be interpreted with caution and regarded as hypothesis-generating. Prospective validation in randomized controlled trials is warranted to confirm these observations.
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BibTeX
@article{long2026efficacy,
title = {{Efficacy and safety of air-flow beds for autologous hematopoietic stem cell transplantation in multiple myeloma: a retrospective cohort study}},
author = {Zhangbiao Long and Dinghui Zhao and Min Ruan and Yutong Jin and Yuxin Li and Zhengfeng Hou and Jian Hong and Jifei Dai and Xinglin Liang and Qingsheng Li and Jian Ge},
journal = {Frontiers in oncology},
year = {2026},
month = sep,
doi = {10.3389/fonc.2026.1953570},
url = {https://europepmc.org/article/PMC/PMC13661374},
note = {CC BY},
}
RIS
TY - JOUR
TI - Efficacy and safety of air-flow beds for autologous hematopoietic stem cell transplantation in multiple myeloma: a retrospective cohort study
AU - Zhangbiao Long
AU - Dinghui Zhao
AU - Min Ruan
AU - Yutong Jin
AU - Yuxin Li
AU - Zhengfeng Hou
AU - Jian Hong
AU - Jifei Dai
AU - Xinglin Liang
AU - Qingsheng Li
AU - Jian Ge
PY - 2026
DA - 2026/09/30
JO - Frontiers in oncology
DO - 10.3389/fonc.2026.1953570
UR - https://europepmc.org/article/PMC/PMC13661374
AB - Background: Autologous hematopoietic stem cell transplantation (ASCT) is the standard consolidation therapy for multiple myeloma (MM), but its widespread implementation is constrained by the high cost and limited availability of conventional laminar airflow rooms. The air-flow bed, a single-bed unit equipped with high-efficiency particulate air (HEPA) filtration providing class 100 (ISO class 5) air quality, represents a more accessible and cost-effective alternative. Methods: In this retrospective cohort study, we compared the efficacy, safety, and costs of ASCT performed in air-flow beds (Group A, n=91) versus conventional laminar airflow rooms (Group B, n=60) in 151 MM patients treated between 2022 and 2026. Multivariable regression models were adjusted for potential confounders. Sepsis was analyzed descriptively because of the small number of events. Platelet transfusion requirements were analyzed using negative binomial regression. Results: Engraftment outcomes were comparable between groups. Group A showed significantly lower rates of mucositis, diarrhea, and nausea/vomiting, and no sepsis events occurred in Group A compared with four cases (6.7%) in Group B. Pathogen detection rate was lower in Group A than in Group B (5.5% vs. 15.0%, P = 0.050). In negative binomial regression, air-flow bed use was independently associated with a lower number of platelet transfusion units (IRR = 0.50, P<0.001). Higher CD34+ cell dose was also independently associated with fewer platelet transfusions (IRR = 0.94 per 1×10 ⁶ /kg increase, P = 0.003). Sepsis occurred exclusively in Group B (4/60, 6.7% vs. 0/91, 0%). With only four events and complete separation between groups, multivariable logistic regression was not statistically reliable. This finding is therefore reported descriptively and no adjusted effect estimate is presented. Median total costs were significantly lower in Group A (¥121,738 [approximately $16,908] vs. ¥137,506 [approximately $19,098], P = 0.0002). No transplant-related mortality occurred in Group A, whereas one patient (1.7%) in Group B died. Conclusion: These findings suggest that air-flow beds may represent a safe, effective, and economically viable alternative to conventional laminar airflow rooms for ASCT in MM. Because protective environment and transplant era were strongly intertwined, these observational associations should be interpreted with caution and regarded as hypothesis-generating. Prospective validation in randomized controlled trials is warranted to confirm these observations.
SN - 2234-943X
ER -