The Stem Cell Transplant Process
Working with referring providers
Communication between our team and referring physicians is critical to the long-term success of patients. We offer next-day evaluations for urgent referrals. We are in regular communication with your pediatrician throughout the transplant process (before, during and after) to keep them informed of your child’s progress.
Evaluation and preparing for transplant
Preparing for transplant can be a difficult time for patients and their families. The length of time leading to transplant varies. If the transplant donor is someone other than the patient, the process of “tissue typing” family members for potential donors, or the search process for an unrelated donor can be time consuming and emotionally straining. Some patients may need additional chemotherapy or radiation to reduce their disease further, prior to coming to transplant. Additional testing is necessary to determine each person’s eligibility for transplant.
Whether these issues take days or months depends on several things, including the type of transplant your child is anticipating, their disease status, and their general state of health. We will try to give an approximate time frame so that you can make the necessary preparations for admission and recovery period.
After the conditioning chemotherapy, your child is ready to receive their transplant. The infusion, or transplant, is done very much like a blood transfusion. If they are receiving stem cells from a donor other than themselves (an allogeneic transplant), the infusion is given soon after the stem cells are collected. The transplant is given through the IV catheter, much like other blood transfusions.
If your child receives their own stem cells (an autologous transplant), a blood bank technologist will bring the frozen cells to the room for thawing immediately before infusion. You may experience some side effects from the preservative used to protect the cells during the freezing and thawing process.
During your inpatient stay
The outstanding support you received in the pre-transplant process does not stop when your child is admitted for their transplant procedure. Sarah Neumann, our inpatient nurse coordinator, will be there every step of the way. You will continue to have access to the same services you may have needed prior to your transplant admission.
Recovery and long-term follow up
Approximately two to four weeks after your transplant, your bone marrow should show signs that it is engrafting or starting to grow. This will be evaluated by drawing a sample of your blood. The first sign of engraftment is the production of white blood cells called neutrophils (ANC). Platelets and red blood cells often take a little longer to begin developing. Once you have engrafted and your condition is stable, you will be discharged from the hospital.
Patients must stay in the Nashville area for the first 100 days after allogeneic transplant. Although each person varies in how long he or she takes to recover, the following are general criteria used for discharge from the hospital:
- Infections or graft versus host disease (GVHD) should be absent, stable or under control.
- Not requiring daily transfusions (especially platelet transfusions)
- Able to tolerate oral medications, food and fluids
- Active enough to function outside the hospital
- Discharge teaching has been completed for you and your caregiver