Transplant Optimization Program (TOP)

As healthcare innovations advance and treatment options for older adults increase, the Transplant Optimization Program (TOP) at UChicago Medicine plays a vital role in assisting stem cell transplant patients who are at least 50 years old. Patients who are 70 years of age and older who are considering CAR T-cell therapy are also seen by TOP program specialists.

medical oncologist Mariam Nawas, MD, meets with a patient in clinic
Oncologist Mariam Nawas, MD, is conducting research into improving stem cell transplant and CAR T-cell therapy outcomes in patients of advanced age.

Our TOP clinic provides patients with a personalized supportive care plan that fosters more successful transplant and CAR T-cell therapy outcomes. At the TOP clinic, our physicians and advanced practice nurses (APNs) start with a medical history assessment before your visit, followed by a full day of interdisciplinary evaluations with the following teams:

You'll also complete a health status survey, which measures your physical function and activity, other health conditions, medications, social support, social activity, nutrition and emotional health.

Following your visit, our team members complete their evaluations and gather for an interdisciplinary meeting. From this, formal written recommendations are provided to your transplant doctor, and also can be viewed by other team members to optimize your care throughout the transplant process.

You will also attend a follow-up appointment with your primary physician outlining recommendations and a treatment plan.

Tips to Help You Prepare for Your TOP Clinic Evaluations

  • Complete your surveys beforehand to keep your visit on schedule.
  • Dress comfortably (including comfortable footwear).
  • Bring your caregiver and other family members to assist you.
  • Bring a lunch or snack.
  • Avoid scheduling other tests on the day of your visit, as the TOP clinic evaluations will take most of the day. If you want to schedule tests, talk to your clinical research coordinator or nurse prior to the visit.

Communication Before and During Your Visit

Prior to your visit, our team will review your prior treatment for the blood disease, pre-transplant testing, medical history and planned transplant details. During your visit, we will ask you about this information to ensure accuracy. We will also ask about your general function, social support, emotional health and overall symptoms. It is important for us to inquire about your understanding of the need for transplant and what is involved in transplant. This allows us to avoid relaying information you already know, but also highlights areas where more education may be needed.

Support the TOP Clinic

If you wish to make a donation to support our work, please donate online.

View Frequently Asked Questions About the TOP Clinic


CAR T-cell Therapy in Patients of Advanced Age

In this program from the Leukemia & Lymphoma Society, oncologists Mariam Nawas, MD, and Peter Riedell, MD, discuss CAR T-cell therapy in older adults, including research into how geriatric assessments and other considerations help determine who may be a good candidate for the procedure.

Watch Video