Being a bone marrow recipient can create a host of mixed feelings. On “Day Zero,” the day upon which you receive your donated cells, you might feel excited and eager to celebrate. Alternatively, you may feel a bit anxious or scared. Both are normal feelings for this process.
Before Day Zero, or Transplant Day, you will receive a pre-transplant treatment that consists of a high dose of chemotherapy and maybe even some radiation therapy. This is a significant element of the transplant process.
On the day of the transplant, which his usually one to two days after you have been given the preparative regimen above, you may feel tired or perhaps exhibit other symptoms. Your donor may have completed his or her donation right on Day Zero or just the day before.
Typically, the donated cells will arrive in blood bags, which are similar to the ones you see when people donate blood The cells in these bags are then put into your body, or infused, through an IV (intravenous) line. Many times, a central line is used to infuse the cells, and this consists of a tube that has been surgically inserted via a vein in the chest.
Depending upon the volume of the cells, the process could take up to an hour. It typically does not hurt. A nurse will be on hand to check your blood pressure and pulse and to take note of any reactions you might have during the process. You may be mildly sedated during this procedure.
These donated cells are pretty smart, too! They simply know where they need to go in your body. They flow through the bloodstream and settle in the bone marrow as needed. From there, they will begin to grow and produce new red blood cells, white blood cells, and platelets. This process is referred to as engraftment. This is a key component of the transplant procedure. The waiting period for engraftment is up to 30 days. You may feel certain side effects during this time preparative regimen you received prior to the infusion. Some can be serious and some may be mild.
Until your cells engraft, you may received a red blood cell transfusion once a week and two to three platelet transfusions a week. You may also be administered growth factor drugs that will help your body to make more blood cells. These can expedite that engraftment process.
You will have low counts in all blood cells until the donated ones engraft. Your white blood cell count will be low, and it will be difficult to fight off any infections that might occur. As such, the transplant team works diligently to protect you from contracting any infections. Although you will remain at risk for infections for several months post-infusion, this period of engraftment is one of high risk for infection. You may be given drugs that will help to prevent infection, even if you are not displaying any associated symptoms.
After you receive your bone marrow or cord blood transplant, the doctors will monitor your health carefully, especially during the first 100 days after the transplant, as that is the time that you are at risk for complications.
After the donated cells begin to grow and create the new blood cells, your blood cell counts will rise and your immune system will become stronger. However, it will remain weaker than normal for many months. At some point during the first 100 days, you should be able to leave the hospital and receive continued car on an out-patient basis. Initially, you will visit the outpatient clinic frequently, maybe even daily, for your care. You will be instructed on how to prepare your home for your recovery, how to begin healthy eating habits, and your loved ones or care takers will be educated on how to continue with your care while you are at home.
Remember that it is crucial to get enough rest to rebuild your health and strength. Because your body is working hard during this time, you will be tired. Just be patient with the time it takes for your body to heal. Daily exercise is important, if you are able. Many transplant patients have indicated that a daily walk, even if just for a short distance, has helped them. You will soon learn that, over time, you can increase the duration of your exercise periods.
(Information for this article was found at http://www.marrow.org/PATIENT/Donor_Select_Tx_Process/Receiving_Your_New_Cells/index.html)