Pilot Trial of Homebound Stem Cell Transplantation

Inclusion criteria

• Diagnosis of Plasma cell dyscrasia
• Treatment plan including Autologous HSCT
• 18-80 years of age
• Appropriate homebound setting as defined by one of the following:

• Lodging at the MSK Residence.
• Staying at home or a "home equivalent" in any one of the zip codes as outlined in the appendix. Home equivalent is defined as a residence which may or may not be the primary residence of the patient.
• "Home equivalent" must pass the "Home Environment Screening Tool" for homebound stem cell transplantation (not required for other MSK recognized lodging facility).
• Adequate caregiver support as defined by:

• Single or multiple informal caregivers willing and able to provide 24 hour a day, seven day a week supervision of the transplant recipient in their home or "home-like" environment.
• Caregiver willing and able to fulfill the basic stem cell transplant caregiver education requirements as determined by caregiver and healthcare team, including social worker
• Have Wi-Fi connection
• Appropriate third party payer coverage for "Homebound Stem Cell Transplant Program"
• Both patient and caregiver willing to give and sign informed consent.

Exclusion criteria

• Patients with a documented active infection prior to starting their preparative regimen. This includes grade 3 or higher viral, bacterial, or fungal infection.
• Uncontrolled arrhythmias
• Active or uncontrolled pulmonary disease
• Karnofsky Performance Scale (KPS) score <80
• Sorror Co-morbidity index ≥ 4 except in patients with history of resected cancers
• Creatinine clearance (calculated or measured) of < 50 cc/minute
• Inability of patient or caregiver to speak or read English (we currently do not have the manpower to translate nor staff a multilingual homebound stem cell transplant program with adequate educational materials).
• Inadequate housing arrangements
• Inadequate caregiver arrangements