PERIPHERAL-BLOOD PROGENITOR CELLS - ENABLING OUTPATIENT TRANSPLANTATION

Peripheral blood progenitor cells (PBPCs) are becoming the stem cell s ource of choice for rescuing patients from marrow aplasia after high-d ose chemotherapy. Their advantages over bone marrow include avoidance of general anesthesia and more rapid hematologic recovery after transp lantation. More rapid engraftment can reduce the risks associated with transplantation and shorten the hospital stay or, under certain circu mstances, eliminate it. The cost reductions associated with a shorter stay have made PBPC transplantation cost-competitive with more convent ional therapy. The move to outpatient transplantation requires increas ed patient and family involvement with posttransplantation care, as we ll as increased patient education and a multidisciplinary care team fo r the safe transition of patients between care sites. Improvements in outpatient transplantation may incorporate a cooperative care model wi th the intent of reducing readmission rates and extending this modalit y to most patients who undergo autologous transplantation.