When you have a bone marrow or cord blood transplant (also called a BMT), the day you receive your donated cells is often called "Day Zero." Patients have different feelings about this day. For some patients, it is a scary time. For others, it is a time of celebration.
Before you receive your new blood-forming cells, you will be given pre-transplant treatment of high dose chemotherapy and perhaps radiation therapy. This pre-transplant treatment, or preparative regimen, is an important part of the transplant process. To learn more, see The Preparative Regimen
Day Zero — transplant day — usually comes one or two days after you complete the preparative regimen. You may be tired or have other early side effects from your preparative regimen. If you receive cells donated by an adult donor, your donor completes his or her donation either on Day Zero or the day before. If you receive cells from an umbilical cord blood unit, the unit will be shipped to your transplant center sometime before your transplant. To read more about how your new cells get to you, see Getting Your Donated Cells to the Transplant Center.
The donated cells arrive in blood bags, just like the ones used to collect blood from blood donors. The color and amount of fluid depend on whether the cells were collected from marrow, peripheral blood or an umbilical cord and whether the red blood cells were filtered out.
The cells in the bags are infused (put into your body) through an intravenous (IV) line, much like a blood transfusion. Most of the time the cells are infused through a central line. A central line is a tube that has been surgically inserted into a vein in your chest. (For more information about central lines, see Getting a Central Line and Entering the Hospital.)
The infusion process takes about one hour, sometimes longer, depending on the volume of cells. The infusion usually does not hurt. A nurse will watch your blood pressure and pulse and watch for any reactions while you are getting your new cells. Some people have mild side effects like those of blood transfusions. These side effects do not last long. You will be awake to receive the donated cells, although you may be mildly sedated.
The donated cells "know" where they belong in the body. They move through your bloodstream to settle in your bone marrow. This is where the donated cells will begin to grow and produce new red blood cells, white blood cells and platelets. This is called engraftment.
To read about the next step in your transplant process, see Waiting for Engraftment: Days 0-30.