Preparing for blood stem cell transplant

There's a lot to do as you get ready for a blood stem cell transplant (also known as a blood or marrow transplant, bone marrow transplant or BMT). Transplant can impact many parts of your life. It may feel daunting, but there are steps you can take to prepare yourself and your family for transplant day and beyond.

Being diagnosed with a serious illness and going through a major treatment such as transplant can be overwhelming. You may be experiencing many emotions, including grief and loss.

Notice and acknowledge your feelings, then make a plan to work through them in a healthy way that's best for you. Not talking about or ignoring your feelings can affect your physical and emotional health.

Something as simple as talking to others may help you:

• Sort through your feelings
• Ease stress
• Put things in perspective
• Decide which treatments to have

You and your caregiver may find it helpful to hear about other patients' experiences. Our NMDP^SM Peer Connect program can connect you with a trained volunteer who's been in your shoes. No matter where you're at in the process, recipients and caregivers like you are available to talk by phone or email, sharing their experience and tips.

Request a connection

Planning ahead helps you focus on getting better during your transplant and worry less about what needs to be done at home.

Here is a basic checklist to get you thinking as you prepare for a blood stem cell transplant:

• Make a list of important phone numbers. Share the list with the entire family. Include names and numbers of your health care team and caregivers.
• Write down important information about finances. Tell your caregiver where you’ll keep this information.
• Ask your bank what you need to do so your caregiver can handle certain transactions for you.
• Plan how your bills will be paid while you’re in the hospital and during recovery.
• Ask for help with household chores and other duties.
• If you have children, set up schedules and make plans for how they’ll be cared for while you’re away. Tell your children and others involved about the plans you make.
• If you’re the only one who can allow medical care for your children, provide a medical release that gives permission to your caregiver or another person you trust. Ask your children’s doctors to give you a medical release form.

Find more information and checklists to help prepare for your transplant in our Allogeneic Transplant booklet (Opens in a new tab).

Matching donors and patients for a blood stem cell transplant is much more complicated than matching blood types. Finding a donor can take time. Learn about the NMDP Registry^SM, how patients and donors are matched and the process your doctor uses to find a donor.

Finding your donor

You and your doctor will work together to decide which transplant center is best for you. There are several factors to consider when making this decision. Find detailed information on transplant centers in the United States.

Choosing a center

If you hope to have children in the future, talk to your doctor before treatment starts. Access questions to ask your doctor begin the conversation about fertility when discussing treatment options.

Considering your fertility

An advance directive (often called a living will) can help you be more in control of your care. It is critical for making sure your loved ones and health care team understand your treatment wishes if you’re not able to speak for yourself. Find information on preparing an advance directive.

Preparing an advance directive

Before transplant, you'll have doctor's appointments, tests and treatments to check your overall health and prepare your body for transplant. Read more about what to expect in the days and weeks before transplant day.

Treatment for transplant

Usually 1 or 2 days after you finish your preparative regimen you will receive your new cells. The day of transplant is often called "day zero."

When day zero arrives, it's normal to have many emotions. You may feel nervous, wondering how your recovery will go. At the same time, you may want to celebrate the day that your new cells arrive. Your hospital chaplain, leader in your faith community or social worker can be a source of support for you.

You may wish to:

• Have a blessing service
• Dedicate a time for reflection
• Write about your experience and feelings in a journal
• Take a picture of you with your new cells

A transplant is not surgery. Instead, the healthy cells from your donor are given to you just like a blood transfusion using your central line.

You'll be in your hospital room and awake during the transplant. Your transplant team will watch you closely while you get your new cells. They'll also explain what to expect, how long it might take and how you might feel.

The process of receiving (infusing) the new cells through your central line can range from less than an hour to a few hours. The length of time can depend on the number (volume) of cells you receive and how your body responds.

The blood stem cells will travel through your bloodstream, settle into your bone marrow and begin the process of engraftment—growing and making new blood stem cells.

Learn about engraftment

There are some risks surrounding a blood stem cell transplant. Your health care team can help you understand those that may affect you. Graft-versus-host disease (GVHD) is a common complication after an allogeneic transplant (when you receive cells from a donor). It’s important to recognize the signs and symptoms of GVHD so treatment can start as soon as possible.

Understanding GVHD

Sometimes transplant doesn’t work. Your body may not accept the donated cells or the disease may return. It’s not your fault. Learn about why transplant may not work and other treatments that might be available.

What if transplant doesn't work?