Table 3.

Summary of how we transplant

Technique and the mobilization procedure
Selection  Up to age 76 years.  No restriction for renal function.  No requirement for response to induction. Mobilization (see Table 1)  Patients aged <70 routinely undergo collection for 2 transplants.  Plerixafor not standard.  Chemotherapy mobilization if circulating cells by flow or if no response to induction.
Conditioning  Standard nonprotocol remains melphalan (200 mg/m2) for fit patients.  Melphalan (140 mg/m2) if patient is frail or serum creatinine ≥2.0 mg/dL.
Procedural  Conditioning, infusion, and postinfusion monitoring usually are performed on an outpatient basis.
• Oral antibiotic prophylaxis: penicillin, levofloxacin, acyclovir, and fluconazole
• Manage breakthrough fever of >38.5°C with vancomycin (3 days if culture negative) and cefepime (outpatient).
• Anticipate that half of patients will complete treatment as outpatients.