Peripheral blood progenitor cells: enabling outpatient transplantation

Peripheral blood progenitor cells (PBPCs) are becoming the stem cell source of choice for rescuing patients from marrow aplasia after high-dose chemotherapy. Their advantages over bone marrow include avoidance of general anesthesia and more rapid hematologic recovery after transplantation. More rapid engraftment can reduce the risks associated with transplantation and shorten the hospital stay or, under certain circumstances, eliminate it. The cost reductions associated with a shorter stay have made PBPC transplantation cost-competitive with more conventional therapy. The move to outpatient transplantation requires increased patient and family involvement with posttransplantation care, as well as increased patient education and a multidisciplinary care team for the safe transition of patients between care sites. Improvements in outpatient transplantation may incorporate a cooperative care model with the intent of reducing readmission rates and extending this modality to most patients who undergo autologous transplantation.