Blood and Bone Marrow Transplant Step-by-Step Guide
If you or someone you love needs a blood or marrow transplant, understanding the following six steps will help.- Referral and initial consultation
- Pre-transplant evaluation
- Patient selection process
- Preparation and transplant
- Post-transplant care
- Long-term follow-up
1. Referral and initial consultation
After your doctor tells you that you may need a blood or marrow transplant, he or she may call a physician or a transplant coordinator on the medical staff at Baylor to set up a date for specialists to examine you.
Before your appointment, Baylor will call you with general information and instructions. We will send you a confirmation letter, map, and information packet. We also will get your medical record and test results from your doctor. At your initial consultation at Baylor, you will meet with a transplant physician, nurse coordinator, and insurance coordinator to discuss treatment options and financial issues, and we will review the potential benefits and possible risks of the transplant procedure.
2. Pre-transplant evaluation
Once you and your doctors decide that a transplant is best, you will start your pre-transplant evaluation, which is normally an outpatient process, but one that can be done in the hospital as well. A number of tests will be performed to ensure that you are physically ready to undergo the transplant. Your transplant physician will outline a treatment plan, which may include chemotherapy and/or radiation therapy. The evaluation may also include such tests as family tissue typing or diagnostic testing. Your physician will ask for your consent prior to treatment.
3. Patient selection process
The patient selection decision is always made on an individual basis. Using guidelines of age, general physical condition, diagnosis, and stage of disease, the transplant clinical team will evaluate your medical suitability for transplantation.
4. Preparation and transplant
To destroy cancerous cells, high-dose chemotherapy may be given--with or without radiation therapy. The transplant physician chooses a specific treatment regimen based on the disease. The blood or marrow transplant occurs much like a blood transfusion--through an intravenous (IV) needle. From transplantation until the marrow engrafts and produces normal marrow cells (white blood cells, platelets, and red blood cells), you will be at risk for bacterial, viral, and fungal infections and bleeding. Advanced supportive care is necessary until you recover.
5. Post-transplant care
Inpatients stay in the hospital from two to four weeks to about three months after the transplant, depending on the disease, type of transplant and treatment. During this time, quality care is provided by our specialized transplant nurses, including one-on-one care, if necessary. Patients are at the greatest risk for having complications during the first three months after the transplant, and complete recovery of the immune system takes about one year. In addition, blood and marrow transplantation services are now available in an outpatient setting for some patients, further reducing the need for hospitalization.
6. Long-term follow-up
When you return to your regular doctor's care, the blood and marrow transplant physician will give your doctor a complete written summary of your follow-up treatment, as well as a discharge packet with information about additional recommendations, possible complications, and other important issues.
A blood and marrow transplant physician is available 24 hours a day to answer any questions. It's important to continue to include the transplant physician in your care because the specialist is better able to identify and address long-term complications. We encourage transplant recipients to return to Baylor for an annual check-up in the first two years after your transplant.