What to Expect: The bone marrow transplant procedure

“It was a scary situation. Some people are really nervous – and that’s OK.
But having a positive attitude was important.” – R.R.

Patients have many different feelings about bone marrow or stem cell transplants. Some people are hopeful and see the transplant as the chance to start a new life. Some people are fearful – an understandable response.

Knowing what to expect before you head into the transplant procedure can help you feel better prepared for the treatment.

“The nurses and doctors were very reassuring.” – D.G.

Conditioning Phase: Pre-transplant high-dose chemotherapy

The conditioning phase helps prepare your body for the transplant. Patients are treated with one of several regimens, which can include the use of chemotherapy alone or chemotherapy with total body radiation. This preconditioning allows your body to accept transplanted cells and also allows the highest success by eradicating the cancerous cells.

Side effects are likely to arise as a result of the chemotherapy and radiation received in the conditioning phase. During this phase, you may experience:

• Nausea and vomiting
• Mouth and skin sores
• Hair loss
• Sore throat
• Diarrhea

Infusion of hematopoietic stem cells
The actual transplant is a fairly simple procedure. The bone marrow or stem cells are infused into the body through a central venous catheter, similar to a blood transfusion.  The new stem cells gradually move to the bone marrow space and start to develop new marrow. This process is called "engraftment," or marrow recovery, and usually begins to occur within 10 to 21 days after the transplantation.

In autologous stem cell transplantation, a preservative is added to the cells which may cause you to experience an unusual taste and odor.  Patients receiving allogeneic stem cell transplantation may experience a chill or fever after the procedure.

Recovery Period
Whether they undergo an autologous stem cell transplant or an allogeneic bone marrow transplant, most patients should plan on spending 21 to 30 days in the hospital.

During the time period following transplantation but before the engraftment process begins, patients are given red blood cell and platelet transfusions as necessary. Because the bone marrow is not yet able to manufacture white blood cells and other cells of the immune system, there is an increased risk of infection during this time. Patients receive intravenous fluids because oral intake must be decreased during recovery.

“There were times it was difficult.  But I forgot everything I went through once I got the results – 100% remission!” – D.G.

Complications and /or side effects of bone marrow transplant:
If you receive an autologous stem cell transplant, you will be at risk for infection for xx months following the transplant. It may take up to two months before you regain your energy. You may also experience nausea and diarrhea for a few weeks after the transplant.

Patients who receive an allogeneic transplant require close follow up. You must receive immunosuppressive medications to prevent your body from rejecting the donor stem cells that you received during the transplant. Like patients undergoing autologous transplant, you will be at greater risk for infections. This makes it necessary for you to remain in isolation until…

If you receive an allogeneic transplant, you will also be at risk for developing graft-vs-host disease (GVHD). GVHD occurs when infection-fighting cells from your donor recognize your body as foreign. The infection-fighting donor cells then attack tissues in your body just as if they were attacking an infection. GVHD can affect the eyes, skin, liver, stomach and intestinal tract.  Its effects can range from mild to severe.