Experience with BMT on an outpatient basis?

Someone from Mayo will post like Lori, but my experience with a BMT at City of Hope in California is a room on Floor 6 of the hospital for 26 days. The day i showed i had consistent uptick in improvement, i went offsite till i hit 100 days. I have read that places start the treatment in person but move to a place close offsite so they can return for a check every day.
What is the offsite procedure they use?

@katgob,

Thank you for sharing your experience at City of Hope.

We live less than 20 miles away, but with traffic, it will take 45 minutes to an hour to get to the facility. We meet with them next week to get a formal roadmap, but they indicated we would be on-site for 4 to 8 hours each day, and the remainder of the time we could stay at home or a local hotel. Also, we don't qualify to stay at the Kiwanis house, which is close by, but they offer discounted rates at a local hotel within 10 minutes.

We started our journey at Sutter Health, but we recently switched to UC Davis, as they are a comprehensive cancer center with an NCI designation and several Myeloma experts. We've been here two weeks, and the care has been excellent. I was just surprised to learn this procedure was done on an outpatient basis.

We told our team that we are uncomfortable doing this procedure on an outpatient basis. Will see how our meeting goes next week.

Good morning, Tina @tmharbison. Reading your post this morning about your husband being an outpatient…I just had a flashback to 6 years ago learning that my bone marrow transplant would be outpatient at Mayo Clinic. This was such a shock to me after the collective 8 weeks spent as a patient at my local hospital. There’s a level of comfort and security being surrounded by care 24/7, right? Well, my fears turned out to be unfounded as my care was exemplary!

If your husband has MM, he most likely will be having an autologous stem cell transplant, using his own cells. While he will be an outpatient, he will be required to stay near the clinic for a certain period of time. Generally it’s 4 to 6 weeks. So, while he won’t necessarily be IN a hospital 24/7, during recovery he will be seen daily by his SCT team.
From my own experience and that shared by others here in the forum, IF there are any concerns or issues, we’re admitted to the hospital ASAP. So being outpatient doesn’t mean he won’t get the same intensive level of care.

There can be advantages to not being in a hospital setting long term. In my case, my husband and stayed in a hotel suite 2 blocks from the clinic. I was in-patient for the last 2 days of my 5 days of chemo until the transplant a couple days later. (I had a Allogenic transplant so my chemo was different than your husband’s.) A day after the transplant I was then released to recover ‘at home’ in my hotel suite. I loved having my own bathroom, the ability to shuffle to the fridge to get snacks, etc.. I reported to the clinic daily for blood tests and exams. But not being in a hosptial, I wasn’t exposed to potential germs, I got more exercise, better food, uninterrupted naps, and the like. My husband and I really embraced the out-patient experience.

Typically, preconditioning chemo for MM generally tends to be 1 or 2 infusions and not very eventful until about a week later; Similar to other chemo treatments. So it’s not uncommon to be administered as an outpatient in an infusion center. Your husband will most likely be given anti-nausea meds as a precaution. But certainly if he has any side effects or there are concerns, his team will be right there to act accordingly and would admit him right away.

There are several members who have had a SCT for MM and share their stories. Here are a few links for you to read that might be helpful for your preparation.

This was posted by @jstpeachey a few years ago but it’s still quite relevant and filled with great info:
One-week pre Autogolous BMT: I'm afraid I'm not prepared
https://connect.mayoclinic.org/discussion/1-week-pre-autogolous-bmt-712/
***Particularly this comment
https://connect.mayoclinic.org/comment/889456/
I hope this is all helpful for you. We’re here if you have any concerns. How long does your husband have to remain near the clinic?

Hi Lori,
I am scheduled to meet with a bone marrow transplant specialist that works for Kaiser and City of Hope. My O/H here said that was the best she could do for me as Kaiser does not have MPN specialists. She also said that because my scores for Myelofibrosis came back very low risk and low risk on another that I would not be a candidate for for BMT now as risk outweighs benefit now. She said once person is 70 years old, it cannot be done. I am 65 so it is probably good to learn about it. It will be a two hour drive plus more time for traffic but I would think it is good to get another opinion. I wonder if doctor there can distinguish better if I have ET or Myelofibrosis or something else. It does not matter as I still feel just fine with no symptoms and great energy level doing cardio with daily walks and cycling around our golf course and park, weight training, and stretching and yoga with my daughter who is super into her exercise class. I am very busy here with lots to do. We have a great garden, many blooming flowers, beautiful weather now, I work part time, and really do not spend much time thinking about my possible illness. I take my BP each morning (it is normal) and do take baby aspirin daily as my platelets have been high each lab I have had since December 2024.
If I do need a BMT down the road, I assume mine would be the type you had with donor cells. How many days did you have to stay in sight in the hospital total? I have only had to stay overnight in a hospital one night when I delivered my daughter 33 years ago and I could not sleep a wink, even with medication. Any amount of time required to be in a hospital would not be a positive experience for me I know.
Thanks for listening. You and this group are very helpful for information.

Hi @1pearl, Being low risk with your MF diagnosis you may not have any issues in the future where you’d need a BMT, but it’s good that you’re being proactive ‘just in case’.

Being super active with your equally positive attitude will serve you well if you do require a BMT at some point. ☺️
Like you, I hadn’t been hospitalized since the birth of my daughter or seldom ill! I was extremely healthy until boom, the rug was pulled out from under me with AML. I had my allogenic transplant at 65 after several months of intense chemotherapy. I’ll be honest, recovery isn’t immediate. It’s
slow and steady and takes months. But I was back to walking a couple of miles daily by 1.5 months. It didn’t take long after that to get back to 8 miles…it been 10 miles daily previously. At 71, I still walk 8 miles daily, plus weight bearing exercises, gardening (with a mask!), travel, etc.. So my life is full and back to 98% normal.

Each transplant facility will have their protocol for transplants. I was in Mayo Rochester where I was expected to be near the clinic for 100 days with a caregiver. I was outpatient, not in the hospital except on a limited basis when needed. Though I did report to the clinic daily for progress checks, labs and infusions.
Other clinics may have a patient in the hospital for a month or so and then off campus nearby for recovery. Questions you may want to ask…In Patient or Out Patient? How long will you be in a hospital. How long will you be required to stay near the facility? Will I need a full time caregiver?

My husband and I stayed in a hotel suite 2 blocks from the campus. I felt being outpatient was a great option. I loved my independence and not feeling like an invalid. I could sleep soundly at night or nap any time. We had a full kitchen so my husband always had food for me, had my own (less clinical) bathroom, I had more exercise walking around the apartment than being confined to a room, avoidance of hospital germs, etc..
Each BMT clinic will also have their own protocol for age requirements. I’ve mentored several people who were 75 at the time of their transplants…now in their 80s and doing great! Some clinics have an age cutoff, some go by the patient’s determination, stamina, ability to withstand the chemo and medications…also taking into account any co-morbidities.
I see that you’ll be talking with a BMT counselor at COH. One of our awesome members, @katgob had her transplant at COH in Duarte, CA. She’d be happy to chat with you about her experience. But we’re putting the cart before the horse…you may not even need the transplant.

We’re here for you if you need any clarification after all the info gets tossed at you!

Hi Lori,
Thank you so much for you reply, great questions for me to ask, and such an uplifting post. I really appreciate it and any other info from anyone who has gone through experience similar to what I may face down the road.
Have a blessed day!