Check in with the admissions department when you arrive at the hospital and take care of any paperwork that has not previously been completed. Once you have settled into your room in the blood and marrow transplantation unit, blood will be drawn from your catheter for additional tests. You may also need blood transfusions before treatment begins.

It is very natural to be apprehensive about any procedure, especially one involving discomfort and inconvenience, even though it may be essential in the treatment of your disease. Talk with your doctor about any fears or concerns you are experiencing. Your well being is the first priority of every member of your blood and marrow transplantation team, and they are prepared to provide help on every level. Please ask!

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Treatment for the malignant disease

Administering the Stem Cells

Protective Isolation

Feelings Count

Chemotherapy, using anticancer drugs to destroy cancer cells, can be administered intravenously or orally and is usually given over a period of several days. When chemotherapy is given in large enough doses to destroy the cancer cells, it also severely compromises your immune system. This effect also decreases the chances of your body rejecting the blood and marrow transplantation. Chemotherapy can be used independently, or in combination with high doses of radiation therapy.

Common side effects you may experience include nausea, vomiting, diarrhea, loss of appetite, hair loss, skin reactions, mouth sores, and fatigue. Your doctor and members of your transplant team can help manage these side effects with medication, and reduce any discomfort. 

Total body radiation destroys cancer cells that may remain after the chemotherapy and also further suppresses the immune system. Treatments may be administered over a period of several days, usually with two or three treatments a day. During the treatment, you will not feel any pain, but common side effects following treatment include nausea, vomiting, lack of appetite, diarrhea, and fatigue. Your skin may appear to have a slight sunburn. Medication can help control or prevent the nausea and diarrhea. Relaxation exercises and imagery can also be helpful.

During this treatment you may feel tired and nauseated much of the time, and may not want to have any visitors. Your blood and marrow transplantation team will monitor your condition closely. They will help you manage the side effects that do occur, and help your family members provide their important support.

Infusion

Approximately two days after the treatment phase has been completed, the stem cells will be infused into your system through your central venous catheter. This is referred to as "Day Zero." The infusion will take place in your room and is similar to a blood transfusion. Although there are few side effects, your vital signs will be continuously monitored. The most common side effect is a bad taste in the mouth or an unusual odor, caused by the substance used to cryopreserve the cells. Other side effects might include nausea or coughing. Again, medication can help control or minimize these side effects.

Because you are at high risk for developing an infection, and the only sign of infection may be a high fever, your temperature will be taken often. You will be given antibiotics and other medication through the central line to guard against infection and other potential complications.

Protective Isolation

All rooms are protective isolation and you will be admitted to one. After the infusion or shortly thereafter, you will return to protective isolation. Special restrictions will be placed on visitors and items brought into your room.

During this phase of your care, it is important that any visitors follow the rules of protective isolation.

Feelings Count

During your hospital stay, you may experience an array of emotions, including depression, anxiety, fear, anger, guilt, and relief. While you are not feeling well, emotional stress may also begin to affect you. After a period of time in isolation, you may feel disconnected to the "outside," no matter how often you have visitors. You may feel a loss of control and uncertainty. Even the hospital routine -- early mornings, set hours for visiting, activity schedules, and other details can be stressful. Then, as you begin to feel better, you may feel bored and tired of being in the hospital.

These and all of the emotions you are experiencing are normal. It may be helpful to remember that you are sharing these feeling with the thousands of persons who receive a bone marrow transplant each year. Talk to your doctor and to the appropriate members of your transplant team about how you are feeling. They are good listeners and they are ready to help.

The amount of time you spend in the hospital following the transplant depends on several things, and varies with each patient. Engraftment for the marrow, a milestone in the transplant procedure, usually occurs 9-30 days after transplant. Most often, patients are in the hospital between 3 and 6 weeks.