Before the transplant

Before your allogeneic transplant, you will be admitted to the Blood and Marrow Transplant Unit at the Hospital to begin a conditioning phase. Each room in the unit has special air filtration systems to help protect you from infection. These are called Laminar Air FLow (LAF) rooms. Everyone who enters your room must wash his or her hands. To help prevent infection, you will be allowed out of your room only for special tests.

The conditioning phase consists of several days of chemotherapy or a combination of chemotherapy and radiation. These high-dose treatments kill cancer cells, but also kill normal bone marrow stem cells. Once these stem cells are destroyed, normal blood cell production will cease. Blood or marrow transplants will restore normal blood cell production. The RAC will have been inserted before chemotherapy. Each chemotherapy treatment will take several hours.

A urinary catheter, if indicated, will be inserted into your bladder. This will be used for continuous bladder irrigation due to the possible side effects of some chemotherapy agents. The urinary catheter will be removed after the full course of treatment is completed. On days you receive chemotherapy and radiation, you will be given medications to decrease nausea and vomiting and to help you relax and sleep.

For radiation therapy, if any , you will be transported by ambulance to your appointment at the Radiation Oncology Center . The pre-transplant conditioning phase takes between two and 10 days.

The donor's bone marrow harvest

On the morning of the allogeneic transplant, your donor will be taken to the operating room and given general anesthesia. The physician will remove bone marrow from his/her pelvic bones (the posterior iliac crests). Two or three small incisions are made over each iliac crest and numerous needle sticks will be made in the incisions to draw out the bone marrow.

Because the harvest depletes red blood cells, your donor will receive a transfusion of his/her own blood, which will have been collected a few days or weeks before the harvest.

The donor's lower back will be sore and stiff after the harvest. Pain medications are available to ease the discomfort. He or she may feel lightheaded the first day after the harvest but should be able to resume normal activities within a week. Hospitalization for the harvest procedure is usually an overnight stay.  .