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Bone Marrow/Stem Cell Transplant Frequently Asked Questions
14. What can I expect before and during the transplant?
Just prior to the transplant, you'll receive high doses of chemotherapy and/or radiation, referred to as a "conditioning regimen," to destroy diseased cells in the body. Receiving chemotherapy and radiation is an important part of the treatment and during this time you will be carefully monitored. You can help your medical team during this period by letting them know if you experience anything unusual and if you are feeling pain or other symptoms. Be a good communicator. Conversations with your health care team are particularly important at this time.
The chemotherapy and/or radiation will also destroy the stem cells in your bone marrow and severely weaken your immune system. This is a time when you will be very immunecompromised, which means that you'll be susceptible to infection. During this time, you'll have to be very vigilant about guarding against bacterial, viral, and fungal infections. This entails staying away from sick people, washing hands frequently, keeping good oral hygiene with frequent mouth rinses, and eating food that has been meticulously prepared.
The bone marrow/stem cell transplant is a surprisingly simple procedure, very much like a blood transfusion. On the day of transplant, you'll receive the stem cells that were taken from either you or a donor through an IV (intravenous), just like any blood product or medication. It takes one to two hours for the infusion. You will be monitored frequently for any reaction to the infusion, but in most cases the process is uneventful. In an amazing process, stem cells will travel through the bloodstream and migrate to the marrow space in the bone. They know exactly where to go. The stem cells from the transplant should begin producing life-sustaining blood cells in about two to four weeks. When peripheral blood stem cells are used, this generally occurs somewhat more quickly than with bone marrow or cord blood.
As your new stem cells establish themselves and start to reproduce (engraft), your risk of infection will start to go down. The time it takes for the new immune system to rebuild itself and become fully functional varies from patient to patient and may take from six months to a year or more. As the new immune system becomes established, the risk of infection declines.
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