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