Your doctor will discuss your treatment plan, the possible side effects of the procedure and possible complications. If you are a man and you are considering becoming a father, you may want to talk to your doctor about saving some of your sperm because chemotherapy and radiation can cause either temporary or permanent infertility. This is called sperm banking.
You should become totally familiar with all of the support services offered by the medical center where the transplant will be performed.
You will undergo pretreatment evaluation and testing, including many blood tests and other tests, such as a chest X-ray and an echocardiogram.
The next step in a bone marrow transplant is to determine where the replacement cells will come from. There are two options. The cells can be taken from the person having the transplant before the main procedures. This is called an autologous transplant. The other option is for the cells to come from a donor. This is called an allogeneic transplant.
If your own cells will be used, these cells must be collected before your main radiation or chemotherapy begins. There are two ways this can be done.
Bone marrow harvesting. The cells for the transplant are taken from the patient's bone marrow. The procedure is done in an operating room with you under general anesthesia so you are not awake. A needle and syringe is inserted into the hipbone and is used to withdraw bone marrow.
Peripheral stem cell harvesting. The cells for the transplant are taken from the patient's circulating blood. A substance called growth factor may be given by injection for several days before the procedure to encourage more stem cells to leave the bone marrow and circulate in the blood. In some cases, chemotherapy is used before the cells are withdrawn to increase the number of circulating stem cells. The procedure is similar to donating blood. A needle will be placed in each of your arms. Blood will flow from one arm through a machine that removes the stem cells. The blood then will be returned to you through the needle in the other arm.
Cells removed either way can be treated to remove any cancer cells, and then stored until the transplant.
If a donor's cells will be used, a donor has to be found whose cells match the patient's cells as closely as possible. It is best if the donor is a close relative because there is a better chance that the cells will match and thus minimize the likelihood of being "rejected." If this is not possible, matching donors sometimes can be found through a bone marrow registry, such as the National Marrow Donor Program in the United States.