Outpatient Stem Cell Transplantation

During an outpatient stem cell transplant, the patient undergoes the full course of treatment (pre-transplant evaluation, conditioning, infusion of their stem cells, engraftment and recovery) on an outpatient basis rather than being admitted to the hospital for three to four weeks of treatment.

The patient and a caregiver make daily visits to our outpatient stem cell transplant unit on the 10th floor of the Center for Care and Discovery. Tests and infusions are performed in a private treatment bay equipped with a comfortable infusion chair. Patients may read, watch a personal wall-mounted TV or surf the web during treatment. Patients typically spend one to three hours at the unit daily for three to four weeks. Each day, when treatment is over, the patient returns home or to a designated hotel near the UChicago Medicine campus. The outpatient unit is open from 7 a.m. to 7 p.m., seven days a week.

Advantages of outpatient stem cell transplant include the following:

• The same, effective treatment course is given while allowing patients to rest after therapy in familiar and comfortable surroundings.
• Daily check-ins with nurses and physicians ensure patients are closely monitored for any signs of infection. If necessary, the patient can be easily transitioned into the inpatient unit for a few days or for the entire remaining treatment course.
• Being home encourages greater movement, such as to and from the kitchen, bedroom and bathroom, optimizing physiologic function. Under certain precautions, patients may leave home, go shopping or elsewhere during outpatient treatment. Moving around and being active contribute to good treatment outcomes.
• Many patients report that being with family and friends at home is beneficial to their overall state of mind during treatment.
  
   

Outpatient stem cell transplant is offered on a case-by-case basis after a thorough evaluation. Our program currently provides outpatient treatment to patients who meet the following criteria:

• Diagnosed with multiple myeloma, lymphoma or other blood cancer and prescribed an autologous stem cell transplant (patient receiving their own stem cells)
• Under 70 years of age (in most cases). Some patients over 70 may be eligible.
• Good overall physical condition with no evidence of significant heart or kidney disease or other relevant medical conditions
• Live within an hour drive of the UChicago Medicine campus or willing to stay at a designated hotel or apartment near campus
• Have a responsible, designated caregiver(s) who can accompany the patient 24 hours a day, seven days a week. Caregivers do not need medical training and can be a relative or friend. There should be one “point person” designated caregiver for communication purposes. Note that other responsible caregivers may assist with transportation, accompanying patients to/from appointments, being at home and more.
• The patient and caregiver agree to follow guidelines to prevent infection. For example, the patient must wear a mask when outside the home and adhere to a strict medication regimen.

Our aim is to offer outpatient stem cell transplant to an even broader group of patients with other blood disorders. Some patients having an allogeneic transplant (transplant from non-twin donor stem cells) may be eligible to have their preparative chemotherapy before the transplant as an outpatient.

For several years, outpatient stem cell transplant has been offered at a handful of leading hospitals, giving physicians experience to determine the best conditions for a good outcome. At UChicago Medicine, our outpatient stem cell transplant service is tailored to deliver the highest quality care to patients who are most likely to benefit from this option. Every step of the treatment process is designed to ensure safe, effective care. Daily visits and our commitment to close communication with patients and caregivers ensure that early signs of infection or other complications are found and addressed in a timely manner.

If hospitalization is necessary, patients are easily transitioned into our dedicated inpatient unit. Even if the patient must spend time in the hospital, he or she may eventually resume outpatient treatment.

Typically, signs of infection, such as fever, confusion, trouble breathing, or development of low blood pressure will require hospitalization. In some cases, we're able to prescribe treatments for these issues an outpatient basis. The majority of patients receiving outpatient blood and bone marrow stem cell transplant therapy will not be admitted to the inpatient unit.

Designated caregivers play a critical role in the treatment process and are essential to a good outcome. There can be more than one responsible caregiver, but there should be a single designated “point person” caregiver who will communicate with the UChicago Medicine team. Requirements for caregivers include:

• Accompanying the patient 24 hours a day, seven days a week during the treatment process. The patient should not be alone.
• Ensuring the patient visits the outpatient transplant unit daily
• Monitoring the patient for signs of infection, such as fever
• Making sure the patient takes the correct dosage of medications on time
• Helping the patient follow guidelines to prevent infection and illness, such as proper hygiene, eating nutritious meals and getting enough sleep
• Keeping a clean, safe environment for the patient
• Being able to contact the UChicago Medicine team with any questions or concerns, and being able to take the patient to our medical campus should the need arise

Whether the treatment is offered in the hospital or on an outpatient basis, patients and their families receive thorough support and education to prepare for all phases of the stem cell transplant process.

Candidates for outpatient transplant and their designated caregivers meet with nursing staff and a social worker to review the process and requirements to ensure a successful transplant. Patients and caregivers receive detailed educational materials that outline medication schedules, care for the central venous catheter, how to spot signs of infection, measures to prepare a safe, clean environment at home and more.

Our team is available 24 hours a day, seven days a week to answer questions and coordinate care.