How long is the average stay for an ASCT? How will the doctor know when I am able to return home or no longer come for daily clinic visits?

How long does the average stay for a autologous stem cell transplant?

So the first question about how long you can expect to be in the hospital or have to be close to a hospital for the transplant. So on average, we tell our patients that for most, it takes about like four weeks for them to kind of fully recover from the transplant, at least the initial part and then be able to go home, you know, to recover at home and then come back and see us in the clinic.

Typically, what factors playing to come into play is if, you not requiring blood transfusions or if you're, white cells have come up.

So we use a term known as, engraftment or stem cell engraftment, which is the stem cells that we have given to you are able to go inside your bone marrow and start making healthy blood back up again.

And, so during that period, which usually takes about 2 to 3 weeks, your blood counts can be extremely low. So you can require blood transfusions, you can require platelet transfusions.

You have a very weak immune system. So you are at a very high risk of infection. So you would be on certain antibiotics and certain medications to protect you from those infections.

And typically what happens is after about 2 to 3 weeks, we start seeing the blood, the bone marrow, start making healthy blood back up again. And, so your platelets start getting better. Your hemoglobin, your red cell start getting better, and your white counts. That's coming up. So once we have reached a point where we don't thank you and require blood transfusions, and your bone marrow is engrafted and your white cells have come up adequately, that you're not at very high risk of infections, is that when we can basically let you go home and recover at home from that period?

So how long do people need to stay around for a transplant? Well, at our center, we after the stem cells go in, we have people stay on the transplant team, which is a separate team from like my clinic. So I'm a multiple myeloma clinician. I see patients and sort of continuity. But we have a separate team to does the transplants.

And when patients are on that team from the time of the start of the stem cells going in to going home or leaving back to where they're from, it's it's usually about a month. So about 2 to 3 weeks for Engraftment and then another weeks for monitoring for any other toxicities. So, in terms of the stay in the hospital, that really depends.

You know, often people will be able to leave once they're if they're they're in for a neutropenic fever. Once they're there, neutrophils are normal and there's no further sign of infection. If it's nausea the nausea has to be controlled. But often this coincides with their engrafting. So usually around you know day 14 to day 21. So it depends in terms of the hospitalization stay.

It really depends on how someone does.

What is Engraftment? How will my doctor know if I am engrafted?

Well, the best analogy I have is, you know, planning, you know, the seeds in a field.

And we're waiting to see signs that we're seeing this, you know, evidence that things are growing. It's the same thing with stem cells. So we want to see the stem cells have taken it's very uncommon. Does not see a engraftment, you know, maybe with other types of transplants that can happen with allergenic transplants or cord transplants, but with autologous or your own stem cells.

The odds of not engrafting are very, very low. So almost everyone in graphs, and we look at the neutrophils the fight or white blood cells and the platelets, those, those cells that help your body clot blood.

And when they get above a certain threshold and it varies from center by center, we would say that someone's engrafted.

Typically we want to see the neutrophils about 1000 and the platelets above 50,000. But but you know those are kind of rough guidelines. But that's usually what we want to see that things are heading in the right direction.