The process for getting a bone marrow transplant is a long one, from early planning all the way through long-term follow-up care.
When you come to BMT Aboad for a transplant:
Here is an overview of the main steps:
Step 1: planning ahead
Step 2: preparation
Step 3: conditioning
Step 4: transplant
Step 5: waiting for engraftment
Step 6: recovering after engraftment
Step 7: long-term recovery
For many people, the process begins with an initial consultation at the BMT Abroad to discuss the possibility of a transplant.
Once your medical team recommends a transplant for you and you decide to proceed, you will begin the seven steps listed below. These steps are described in more detail in Preparing for Transplant.
Once your team recommends a transplant and you decide to proceed, you’ll want to organize your personal affairs and put plans in place so you can give your full attention to your recovery.
Selecting a caregiver: a responsible adult family member or friend to provide physical care, help monitor your health, administer medications, and give you emotional support. Your transplant team will teach your caregiver about these duties. Your caregiver must be available to be with you most of the time for many weeks.
Arranging to live in India for your transplant: if you don’t live here already. We require that you live within 30 minutes of the clinic for your safety. The length of time depends on your disease, treatment plan and response to treatment. A typical range is one month for an autologous transplant and four months for an allogeneic transplant.
Making financial arrangements to pay for your transplant and your living expenses.
Two main elements of preparing for a transplant are:
Preparing the donor
If you are having an autologous transplant (using your own cells), you are your own donor.
For a transplant using peripheral blood stem cells (PBSCs): Your preparation will include stem cell mobilization (receiving medicine that causes stem cells to leave the tissues they normally occupy and to circulate in the bloodstream). Either BMT Abroad or your referring doctor will start this process. After you arrive at BMT Aboad, we will collect your PBSCs.
For a transplant using bone marrow: We will harvest your bone marrow after you arrive in India for bone marrow transplant.
Arriving at BMT Abroad
Once your donor (or you, for an autologous transplant) has been prepared, you will come to BMT Abroad for more preparation.
Transplant workup: On the first day, you will meet with your primary provider and team nurse to discuss your health history, have a physical exam and blood draw, tour the clinic or hospital, get consent forms to review and receive your transplant manual.
Arrival conference: The next day, you will meet with your attending doctor and team nurse to discuss your treatment plan. You will be cared for by a team that specializes in the type of transplant you are having. Your team includes an expert transplant oncologist; a fellow, physician’s assistant or advanced registered nurse practitioner; and a registered nurse, pharmacist, dietitian, team coordinator and social worker. Your doctor will explain the transplant process, including benefits and risks, and answer your questions.
Evaluation for transplant: Over the next one to two weeks, you will have a thorough evaluation to confirm your diagnosis and evaluate your health. This will include tests and imaging
procedures, such as blood tests, bone marrow aspiration and biopsy, chest X-rays and an electrocardiogram.
Data-review conference: After your evaluation, your attending doctor will meet with you to discuss the results, answer your questions and get your official consent, if you want to move ahead with a transplant.
Education: You and your caregiver will attend classes and get individual instruction on topics like what to expect during the transplant process and how to care for your central venous catheter, manage symptoms and maintain proper nutrition.
Donor: If you have a related donor, this person will be with you, and we will evaluate your donor’s health. If you have an unrelated donor, that person will be evaluated at a different center closer to their home.
When you — and your donor, if you need one — are ready, your doctor will begin your conditioning regimen. You’ll receive chemotherapy, total body irradiation or both to weaken or destroy your cancer (or other disease-causing cells) and unhealthy bone marrow.
This will weaken your immune system, making you susceptible to infections, and may cause other side effects. Your team will teach you and your caregiver how to help prevent infections and manage side effects. They’ll also give you medicines to help.
Your transplant involves infusing cells into your body through a central venous catheter (a thin, flexible tube inserted into a large vein).
If you are having an allogeneic transplant, one of the following will happen right before your transplant:
If you are having an autologous transplant:
Engraftment means the stem cells you received are growing and developing. In other words, your bone marrow and immune system are beginning to recover.
While waiting for engraftment :
For transplants with high-dose conditioning :
You will continue to recover as an outpatient. The initial recovery period typically lasts:
About three months after an allogeneic transplant
About one month after an autologous transplant
During this period:
Toward the end of your initial recovery period:
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