Nurse
Practitioner Paul Kaups checking on the first patient treated at the new Day
Hospital. (Photo: UHN)
Multiple myeloma patients are the first in the Greater Toronto Area (GTA) to receive their stem-cell transplants as outpatients in a new six-chair Day Hospital at Princess Margaret Cancer Centre.
The Autologous Transplant Day Hospital, located on 14-627, will treat about 70 patients a year initially, says Dr. Christine Chen, the hematologist leading the program.
Autologous transplants are used to treat patients with various types of cancer and involve administering high-dose chemotherapy to destroy the cancer, followed by infusion of stem cells to rescue the patient's normal bone marrow function that was destroyed in the process. With autologous transplants, the patient's own stem cells are harvested in advance, and prepared and frozen in the Cell Processing Lab until ready for use.
For patients, transplant day – "Day Zero" – begins a three-week recovery period that requires daily assessment by the clinical team to monitor vital signs, blood counts and infections, explains Susan Clarke, Nurse Manager of the Blood and Marrow Transplant inpatient units, Apheresis Unit and the Malignant Hematology Nursing Resource Unit at Princess Margaret.
Until now, this has meant being an inpatient.
"Everything that shaves time off treatment and helps keep patients and their families out of staying in hospital is a win-win," she says.
The autologous transplant team in the new 14th floor Day Hospital, which opened Jan. 5. Back (L to R): Allyson Mayo, Andrew Winter, Karyn McKeever, Christine Chen, Denise Kwan, Paul Kaups, Tasha Murji, Prisco Salvador, Sharmini Varunan; Front (L to R) Rhonda Kibrick-Lazear, Sarah Nagel, and Cheryl Liverpool (Photo: UHN)
Princess Margaret is the biggest cancer centre in Ontario – and the only one in the GTA – doing autologous transplants. About 260 are done there annually and over the past four years volumes have increased by 50 per cent. Dr. Armand Keating started the program in 1986.
The Day Hospital will help manage the waiting list so that patients will not have delays in being transplanted, says Dr. Chen, and it will free up space and services for other patients.
The clinical team has developed a patient safety plan and guidelines for treatment in the Day Hospital. Patients must have a 24/7 caregiver, live within the GTA (no more than a 45-minute drive away), and agree to come for daily assessments for about three weeks.
On the unit, two additional Nurse Practitioners have joined the team, and 23 nurses have been trained to use a telephone triage tool to provide Telehealth-style support around the clock. As well, the team has a contingency plan to accommodate emergency admissions if required.
For more information:
Phone: 416 946 6555
Fax: 416 946 6569
Room: 14-627
