Bone marrow transplant process at Mayo Clinic
At Mayo Clinic, doctors from many specialties work as a team to develop the most appropriate plan of care for you. They take the time to listen to your questions and concerns and provide comprehensive care, including care for nutritional, social, financial and spiritual issues. They follow you before, during and after your bone marrow transplant to ensure the best possible results and quality of care.
Before your transplant
Mayo Clinic doctors trained in bone marrow transplantation and others will evaluate you to determine if a bone marrow transplant or stem cell transplant will be safe and beneficial for you.
Your evaluation may last many days and may include:
- Physical examination
- Blood tests, including blood and tissue type analysis
- Imaging tests, including chest X-rays, CT scans or other tests
- Tests of small pieces of your bone marrow (biopsy) to evaluate your condition
- Consultations with a mental health specialist (psychologist), social worker and others
If doctors determine you're eligible for a bone marrow transplant, you'll be prepared for the procedure. Surgeons will insert a long, thin tube (catheter) into a vein in your chest near your neck. Your treatment team uses the catheter, also called a central line, to infuse the transplanted stem cells and other medications and blood products into your body.
Bone marrow transplants may use stem cells from your own body (autologous transplant), from a donor's body (allogeneic transplant) or from an identical twin (syngeneic transplant).
Doctors have experience performing bone marrow transplants using stem cells from the bone marrow, from peripheral blood or from umbilical cord blood.
You or a donor may have a procedure to remove stem cells from your blood (apheresis) or from your bone marrow. Doctors collect the cells to use in a bone marrow transplant. Stem cells may be frozen until they're needed for bone marrow transplant.
In apheresis, your blood, or your donor's blood, is removed through a catheter and circulated through a machine, which removes and collects stem cells from your blood or your donor's blood. Your blood then returns to your body through a catheter. This procedure usually takes about five hours, and it may take three days or more to gather an adequate number of stem cells.
In surgery to remove stem cells from your bone marrow, doctors insert needles through the skin and into the bone to remove marrow from the pelvic (hip) bones.
After you're approved for a bone marrow transplant, you'll have conditioning treatment to kill cancer cells in your body and suppress your immune system before a bone marrow transplant. Conditioning may include chemotherapy, radiation or reduced-intensity conditioning.
In a bone marrow transplant, doctors infuse or inject healthy stem cells into your body to renew and repair tissue.
After your bone marrow transplant, you may notice some minor side effects, such as a flushed face or nausea, due to the preservatives used to freeze the stem cells. Medications may help with these side effects. You'll also likely be given IV fluids (hydration) before and after the bone marrow transplant to help rid your body of the preservative.
After your bone marrow transplant
Usually you can leave the hospital after your bone marrow transplant, unless you're experiencing allergic reactions or your treatment team needs to watch you closely. You'll usually need to stay close to the hospital for three to six weeks after your transplant. You'll have daily appointments to check for infections and complications and to evaluate your blood cells.
Your transplanted stem cells will begin to create new blood cells. It may take several weeks for your blood counts to recover. Your doctors will conduct blood tests and other tests to monitor your condition and check to see if your transplanted cells are producing new blood cells.
- Follow-up care. Your doctor will update your primary health care provider about your progress and give recommendations for your care at home. In addition, your transplant team will provide follow-up care, answer your questions, and communicate with you and your primary health care provider. You'll have follow-up appointments at Mayo Clinic every one to three months for the first year, and less frequently after that.
You may experience chemotherapy or radiation side effects. Your treatment team can answer your questions about side effects and help you manage them.
- Medications. You may need to take many medications daily after your bone marrow transplant. Your transplant team will discuss your new medications in detail.
- Returning to wellness. The transplant team considers your return to wellness after your bone marrow transplant a priority. You'll be given specific guidelines to return to wellness through an exercise plan and a nutrition plan. Staff may give you other lifestyle guidelines, such as practicing hand hygiene, wearing sunscreen and not using tobacco products.
After a bone marrow transplant, your body is more susceptible to infections and skin cancer, and making certain lifestyle choices may help prevent these conditions. Your transplant team will work with you to help you make healthy lifestyle choices to achieve the best possible transplant outcome.
Read about stem cell transplant. Also see a video about how a stem cell transplant works.
July 11, 2013