Outpatient Blood and Bone Marrow Stem Cell Transplantation
Outpatient blood and bone marrow stem cell transplantation offers the full benefits of this life-saving treatment while allowing the patient to spend nights in the comfort of their own home. At the University of Chicago Medicine, the same team of expert physicians and nurses who provide inpatient blood and bone marrow stem cell transplant care oversee the outpatient program.
- What is outpatient blood and bone marrow stem cell transplantation?
- What are the benefits of outpatient blood and bone marrow stem cell transplantation?
- Who is a candidate for outpatient blood and bone marrow stem cell transplantation?
- Is outpatient blood and bone marrow transplantation safe?
- Under what conditions must a patient transition from outpatient treatment to inpatient care?
- What are the duties of the designated caregiver?
- How does the UChicago Medicine team help the patient and caregiver prepare for the treatment process?
A. In an outpatient blood and bone marrow 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 designated caregiver make daily visits to the University of Chicago Medicine outpatient blood and bone marrow 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 each day 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.
A. Advantages of outpatient blood and bone marrow stem cell transplant include the following:
- The same, effective treatment course is given while allowing patients to rest at home after therapy in familiar and comfortable surroundings.
- Daily check-ins with nurses and physicians ensures 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 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.
A. Outpatient therapy is available to a select group of patients and 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 or lymphoma and prescribed an autologous stem cell transplant (patient receiving their own stem cells)
- Under 60 years of age (in most cases)
- No evidence of heart disease or kidney or other significant comorbidity
- Live within an hour's drive of the UChicago Medicine campus or willing to convalesce at a designated hotel near campus
- Have a responsible, designated caregiver who can be with the patient 24 hours a day, seven days a week. This caregiver does not need medical training and can be a relative or friend.
- 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.
- No pets or young children living in the home during the treatment process.
In the future, outpatient blood and bone marrow stem cell transplantation will be offered to a broader group of patients with other blood disorders and for allogeneic transplants (transplant from non-twin donor stem cells).
A. For several years, outpatient blood and bone marrow transplantation 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 blood and bone marrow stem cell transplantation 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.
A. There is a greater than 60 percent chance that patients receiving outpatient blood and bone marrow stem cell transplantation therapy will not be admitted to the inpatient unit. Typically, bleeding or signs of infection, such as fever, will require hospitalization. However, in some cases, we're able to prescribe medicines to reduce fevers an treat infection on an outpatient basis.
A. The designated caregiver plays a critical role in the treatment process and is essential to a good outcome. Requirements for the caregiver include:
- Accompanying the patient 24 hours a day, seven days a week during the treatment process
- Ensuring the patient visits the outpatient transplant unit daily
- Monitoring the patient for bleeding or 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 the UChicago Medicine campus should the need arise
Q. How does the UChicago Medicine team help the patient and caregiver prepare for the treatment process?
A. 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 blood and bone marrow 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.
- About Stem Cell Transplantation
- Disease-Specific Care
- The Process
- Outpatient Stem Cell Transplantation
- Stem Cell Transplantation for Older Adults
- Relapse: Prevention and Treatment
- Our Team
- Patient Stories
- Clinical Trials
- Polish-American Transplant Center
- Patient Resources
- Second Opinions
- For Referring Physicians