Bone Marrow Transplant Evaluation & Preparation

Pre-Transplant Evaluation

Patients will receive extensive guidance and educational materials about the specifics of transplantation, including the evaluation process, treatment side effects, a realistic timeline, lodging options, financial services and post-transplant issues. Educational materials are reviewed with the patient and caregivers for either an autologous transplant or allogeneic transplant. The bone marrow transplant attending physician, transplant nurse coordinator, social worker and financial coordinator will meet with all patients on their initial transplant evaluation. The pharmacist, behavior medicine team, nurse practitioners and clinic nurses will also help participate in some of the pre-transplant clinic visits to prepare for admission. This evaluation will typically be completed in 1 to 2 days.

In addition to a thorough physical exam and testing, patients undergo human leukocyte antigen (HLA) typing to determine the make-up of their immune system’s cells. This is necessary to ensure that their cells are compatible with a donor’s cells. If the recipient’s HLA type is different from the donor’s, the recipient’s immune system may see the new bone marrow as foreign and may attack or reject it. Or, the donor’s bone marrow may see the recipient as foreign and attack body cells.

Along with HLA typing, blood and marrow transplant patients will undergo some or all of the following tests or procedures before transplant:

  • Bone marrow aspirate & biopsy
  • Echocardiogram/EKG
  • Pulmonary function test
  • PET or CT scans or chest x-ray
  • Behavior medicine evaluation
  • Skeletal survey
  • Lab work
  • Central venous line placement (catheter placement)
  • 24-hour urine collection
  • Psychosocial evaluation

Preparing for your Transplant

Central Line/Catheter Placement

Before stem cell collection for autologous transplant patients or during admission for transplant for allogeneic transplants patients, a central venous catheter will be placed as an outpatient procedure, to facilitate infusion of cells, blood products (if needed) and IV medicines.

Transplantation

The transplant will be performed on an outpatient basis if approved by the insurance payer. If medically necessary, the patient will be admitted and will remain in the hospital during the transplant and recovery.

Lodging During Transplant

Autologous patients need to remain local for 30 days and allogeneic transplant patients need to stay local for 100 days post-transplant. Patients will be referred to a local hotel for lodging. To plan for accommodation in conjunction with the transplant, please contact your social worker or Guest Services.

What to Bring

Patients should plan to bring enough comfortable clothes and shoes for two weeks, including shirts with buttons that enable easy access to the catheter. In addition, patients need to bring their own personal care items, such as shampoo, soap, a new toothbrush, electric razor, lotion and cosmetics.

Entertainment and inspirational items, including books, magazines, puzzles, games, music, music players, knitting and needlework are welcome. However, do not bring items of great value.

No flowers, pets or sick visitors are allowed in transplant rooms.