The Transplant Process
A blood or marrow transplant is a lengthy process that can be physically and emotionally taxing. Though the procedure itself does not take a long time, patients usually enter the hospital at least one week before the transplant for preparatory treatments and then stay for several weeks afterwards to recover.
There are three steps to a blood and marrow transplant: the preparative regimen, the transplant itself, and recovery. Typically, all of these stages take place within the hospital, for a total stay of four to six weeks.
The preparative regimen
Before you can receive the healthy stem cells, you must first undergo a course of chemotherapy and/or radiation in order to make sure there are no cancer cells left in your body. You may receive total body irradiation, or TBI.
High doses of chemo and radiation can be hard on your body. Your transplant care team will help to relieve side effects such as:
- Lack of appetite
- Vomiting and/or nausea
- Pain in the mouth or throat, or “mucositis”
- Loss of hair
- Lower numbers of healthy blood cells
- Retention of fluid (caused by chemotherapy)
- Redness of skin, dry nails, or the loss of nails (caused by radiation)
The actual stem cell transplant is a simple procedure that can be performed in your hospital room. The new stem cells are infused into your body through an IV. Your vital signs will be monitored by your care team, and you can have family or loved ones in the room with you for support.
As you receive the stem cells, you may notice:
- A ticklish sensation in the back of your throat
- Stomach cramps
- Changes in blood pressure
- Bloody urine, caused by the body breaking down the red blood cells in the infusion
Additionally, you may notice a strong smell or taste similar to garlic or creamed corn. The smell may also be observed by others in the room. This is caused by your body expelling the preservative that was used to freeze the stem cells, a chemical called DMSO. The smell may linger on your body and in your room for a few days. To deal with the taste, you can suck on candy or drink flavored liquids during the transplant and afterwards.
After the transplant, you will remain in the hospital for several weeks while the new stem cells take root, or engraft, in your bone marrow and begin producing new cells.
This can be a difficult time for patients. Your blood counts will be at their lowest immediately after the transplant, which means you’ll be at an increased risk of infection and bleeding. You’ll also feel fatigued.
You may receive antibiotics through an IV to treat infections and fevers, and may be given transfusions of platelets and red blood cells. The care team will provide medications to prevent other side effects, such as nausea and vomiting.
Between two to six weeks after your transplant, you should be well enough to go home. You will not be discharged until we are certain that you are in stable health and able to be cared for outside of the hospital. Some key signs we look for are:
- A safe number of white blood cells in the blood
- The ability to eat and drink independently
- No fever
- No vomiting or nausea
We require our patients to attend a discharge class with a nurse to learn more about proper home care and safety.
After leaving the hospital, patients are required to stay within two hours of our transplant center for at least the first 100 days and to have a caregiver available to care for them full time. You will have weekly appointments with your transplant physician to ensure that your recovery is progressing as it should.