Meet with your blood and marrow transplant specialist
The first appointment with your transplant doctor is an opportunity for you to ask any questions. In your first visit, you will:

• Discuss treatment options and the type of transplant that may be recommended for you.
• Discuss process, potential side effects, outcomes and impact on your day-to-day living, activities and quality of life.
• Bring any paperwork and imaging done outside Stanford for your doctor to review.
• Be offered your next appointment to begin the transplant process, if appropriate.

Your first visit is also an important opportunity to tell the doctor and care team about your past medical history and all of the medicines you take – even occasionally.  Some prescriptions, vitamins, supplements, and herbal remedies can affect how your body responds to treatment, so it is important to tell your doctor about all of them.

We can help you get started with a checklist of what to expect and what to prepare.  

First appointment checklist »

We use the information we gathered during your initial appointment to carry out your treatment plan.

Preparing for your transplant
To prepare for your transplant, you will undergo several tests to discover the types of stem cells you need. You  will receive chemotherapy with or without radiation to fight your disease and to prepare your body to receive the new stem cells.

After receiving a preparative therapy of chemotherapy with or without radiation treatment, your ability to fight infections will be compromised. You will need to wear a special filtered mask when you are outside your hospital room and home. You will also need to follow a special diet to control your risk of infection from the foods you eat.

We will monitor you closely throughout your transplant and recover to address any complications.

If you are are to have an autologous transplant, we will give you injections of a medications called growth factors with or without chemotherapy to stimulate your stem cells to move from the bone marrow into  the  blood stream. We will collect your stem cells in a process called apheresis. During apheresis your blood is removed and spins through a machine that will separate the stem cells from the other cellular components of your blood like red blood cells, white blood cells, and platelets. After the stem cells are removed the rest of the blood is returned to you.  Apheresis takes about 4 hours per day and may be carried out over 1 to 5 consecutive days. After the stem cells are collected, they are taken to the laboratory for freezing.

Before receiving your stem cells, you will receive a preparative therapy of chemotherapy with or without radiation therapy. The dose of chemotherapy can range from very low doses to high doses. The preparative treatment is used to eliminate your cancer cells and create space in the bone marrow for the stem cells. The preparative therapy may be given over 1 to 13 days. You may be treated in the hospital or through an outpatient clinic in the cancer center.

During transplant
One to two days after receiving the preparative therapy, the stem cells will be infused  into your body. You should begin making new blood cells 2-3 weeks after the transplant. The recovery of the blood counts is a milestone called engraftment.

The first sign of engraftment is a rising white blood cell count. You will begin to feel “normal” about 3 -6 months after transplant, but full recovery may take a year or longer.

Recovery is influenced by several factors, including the original diagnosis, your age, your overall health, the dose of chemotherapy and radiation you received, and the types of complications you experienced during transplant.

Follow-up appointments
About 100 days after your transplant, your care will be transitioned to your primary BMT physician for check-ups about once every three months. Your doctor will ask you how you are doing, assess your progress, and offer additional care and guidance.

Cancer survivorship and palliative care
Stanford’s cancer survivorship program provides supportive services to help you and your loved ones. Our services address the physical, emotional, psychosocial, spiritual, and financial challenges of cancer and its treatment. We offer classes, health care, and counseling for cancer survivors.

Our cancer survivorship team works with you to develop a plan for transitioning from active treatment to surveillance and ongoing care. We encourage you to contact our survivorship team early in your treatment process. 

Our palliative care specialists work closely with yourcare team to maintain your quality of life and achieve your personal goals after cancer treatment. Some of our palliative care services include:

• Managing your symptoms
• Helping you define your treatment goals
• Helping you with advance care planning
• Providing social workers for emotional and spiritual support

Find out more about our palliative care and other supportive services for people with cancer.

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