How will my transplant be funded? Do I have adequate insurance coverage?
A finance representative will be assigned to work with the patient throughout the transplant process. This begins with getting general transplant benefits and coverage. If financial shortfalls are identified, information will be made available for alternative funding through various resources. The finance representative will also request prior authorization for any necessary procedures.
Who will be my caregiver?
Because it is now possible for a patient to receive much of the transplant regimen outside the hospital setting, a caregiver is necessary to assist with daily activities, grocery shopping, food preparation, self care activities and transportation to and from clinic visits. Caregivers are crucial to help assess the patient for symptoms that should be reported to the transplant team. Additional responsibilities for the caregiver may include dispensing oral or intravenous medications, fluids or antibiotics via an infusion pump. Caregivers can be significant others, family, or friends. It is a good idea to have a group of caregivers to help prevent fatigue and to share the responsibilities.
How long will I have to be in the Salt Lake City area?
Because of the high risk of infection following bone marrow transplant, we recommend you stay near our facility for at least 100 days following most transplants (for allogeneic transplants) and can be much longer following a non-myeloablative transplant. There are some occasions where we allow post autologous patients to return home sooner. How soon you are discharged after your transplant will determine your follow up care. You will be followed in the Outpatient Clinic.
What can I do after the transplant and at what time frame? When can I return to work?
In general, patients are more prone to infection for 6 months following an autologous transplant and up to 1-2 years following an allogeneic transplant. Most patients following an autologous transplant can return to normal daily activities at 3 months after transplant and should be able to integrate back into society at 6 months after transplant.
Allogeneic patients that are on immunosuppression medications are at high risk for infections and therefore, need to limit their exposure to other people and control their environment. These patients usually need to keep their central venous catheter for longer periods of time due to the treatment for graft versus host disease. Allogeneic patients may not be able to return to work for months following their transplant depending on their specific circumstance and immunosuppression.
We ask all patients to wear a HEPA filter mask while they are outside and when they come in medical facilities for at least 3 months post transplant, depending on immunosuppression.
What are the main complications or problems associated with a bone marrow transplant?
The main complication for all types of transplant is infection. Patients are more prone to infection when they are experiencing Graft-Versus-Host disease. These infections can be bacterial, viral or fungal infections and can be life threatening depending on the circumstances.
Graft-Versus-Host Disease (GVHD) is the most common and serious complication following allogeneic transplant. There are two types of GVHD, acute and chronic. Usually the acute occurs within the first 100 days following transplant and can include gastrointestinal tract, skin or liver problems. The onset is fast, requiring quick and aggressive treatment to decrease mortality. Chronic GVHD usually occurs anytime beyond the first three months. The onset is more gradual and complicated to diagnose. It can affect almost any organ or tissue and can resemble one of many autoimmune diseases. The type of transplant you receive will play a major role in the chance of getting GVHD and the severity of this complication.
There are many other complications that are usually manageable and will be discussed in more detail when you meet with the Blood and Marrow Transplant team. These can include bleeding problems, anemia, mouth and throat pain, nausea and vomiting, diarrhea, inactivity, hair loss, and veno-occlusive disease.
What is my chance of surviving following a bone marrow transplant?
Blood and Marrow Transplant is considered a high-risk procedure. The chance of survival depends on your age, disease, status at the time of transplant, type of transplant and co-morbid conditions that may be present. These details will be discussed further upon meeting with the transplant team.
Are there any support groups that I can get in contact with?
There are many support groups available specific to your disease. The BMT social worker will be able to help you get in contact with past patients.
There are also common websites that link together past and prospective patients:
Where is the treatment center located? Can I have visitors?
The Inpatient Unit is at the LDS Hospital on the 8th floor. The unit is fully HEPA filtered and separate from the other Oncology beds. Patients are encouraged to walk around within the unit and visitors are allowed. Hand washing is the single most effective procedure in preventing infection. Before entering and leaving the patient's room, everyone is expected to follow a simple, but thorough hand washing procedure. Anyone who is not feeling well, has a cold, fever or other signs of infection, should not come into the unit. Children are encouraged to visit, except during RSV season (Nov-May) due to the high risk of respiratory viruses during this time of year. The Outpatient Unit is at LDS Hospital on the 8th floor near the inpatient unit.
What will I need to do to determine if I'm a transplant candidate?
Stem cell transplant is a procedure that requires preparation and planning. Your transplant team will be giving you information along with an explanation and support to help you get through this process. After you have met with the BMT physician and it is determined that transplant is in your best interest and you have agreed to move ahead with this high-risk procedure, your BMT coordinator will set up a complete medical evaluation. This will include, but is not limited to, blood tests, x-rays or scans, electrocardiogram, echocardiogram, dental examination, bone marrow aspirate and biopsy, gynecology consultation, and pulmonary function testing.
How will I feel during the transplant process?
Most patients tolerate the initial part of the transplant quite well with potentially some nausea and vomiting, fatigue and possibly some mouth sores depending on the type of transplant. As the inpatient stay continues, patients begin to feel the side effects of the high doses of chemotherapy and/or radiotherapy and this is the time that serious complications and infections can occur. These side effects vary per patient, but at times can actually be fatal. Your transplant team will be watching you closely. They will be monitoring your fluids, blood counts, nutritional needs, and signs and symptoms of infection. This period can be very long and will test your most effective coping skills. We have a social worker that will see you on a regular basis if indicated and help you through this very trying time.