A Typical Patient’s Journey
We strive to provide a relaxed, caring environment to better serve the health care needs of our patients. We know that emotional and mental well-being is as important to healing as the treatment itself.
Steps in a bone marrow transplantation:
- Referral
- Consult Visit
- Chemotherapy
- Medical Clearance for BMT
- Collection of Cells
- Transplant
- Outpatient Follow-up
Referral: Patients are referred for a visit, which is called a consult, to talk with one of the BMT specialists.
Consult Visit: When considering transplantation, the patient meets with the doctor who evaluates their medical history to be sure BMT is the best treatment option. After reviewing the transplantation process, the patient is asked to sign a consent form. The form includes the risks, benefits, and costs of transplantation, as well as other possible treatments.
Chemotherapy: Often chemotherapy is given to wipe out the original cancer once the patient decides to go ahead with BMT.
Medical Clearance for BMT: After chemotherapy, the patient has several days of laboratory and diagnostic tests that allow the doctor to understand the patient’s medical condition. The doctor will decide when the patient is ready for BMT. A dental exam is recommended to make sure the mouth is healthy. This is because the BMT may cause sensitivity.
Collection of Cells: In an autologous transplantation, patients receive their own marrow or peripheral stem cells. These have been collected by bone marrow aspiration or apheresis, explained below. In an allogeneic transplantation, patients receive bone marrow from another person.
- Bone marrow aspiration: The removal of marrow by a needle inserted into the hip.
- Apheresis: Blood is removed through an intravenous catheter or a vein in the arm. The blood is run through a machine that removes stem cells. The rest of the blood is returned to the patient. Typically, apheresis takes five hours and is repeated an average of two times per patient. There is usually no need for hospitalization or anesthesia.
Transplant: After a rest period of four to seven days, the patient is admitted to the hospital to receive high-dose chemotherapy. Although this treatment is designed to kill any remaining cancer cells, it also kills the normal marrow cells that make blood cells. The stem cells that were collected earlier are now given back so the body will begin making its own blood cells again. These cells make their way into the bone marrow, where they begin to make a new population of blood cells. Most patients stay in the hospital three to four weeks.
Outpatient Follow-up: Patients are discharged from the hospital after their blood counts are stable. Follow-up visits continue every 1-2 weeks for the first several months. Later the schedule of checkups is based on each patient’s need. Generally, checkups are done every 2-6 months.
