Continued

Transplant
Day Zero represents the actual transplant day. The donor’s stem cells are infused slowly into the recipient’s circulating blood through a central venous line. In conventional transplants, patients are kept in isolation in order to minimize the risk of infection. Recipients undergoing “mini” transplants may be treated as outpatients.

Engraftment
This is the phase after the first signs of engraftment, when the patient is recovering immune and marrow function. As the new immune system is developing, the goal remains to support the patient's recovery both physically and emotionally. After infusion, the donor’s stem cells migrate to the hollow cavities of the body’s large bones. If all goes well, the stem cells engraft within a few weeks, and begin to produce healthy blood cells (the trilineage includes white cells, red cells and platelets). Early reports indicate that recipients of blood stem cells engraft as much as a week sooner than those who receive bone marrow, thereby reducing the risk of infection and hospitalization time. There is still research underway to determine the effect on Graft versus Host Disease on mini-transplant recipients.

Early Recovery
The recovery process is a long and arduous road. It would be unrealistic to presume that there are no obstacles along the way. A positive attitude is a crucial component for a successful recovery. With some common sense and careful planning, patients can improve their chances of success. Patients should observe caution during these early days post-transplant. For example, immunosuppressed patients should avoid crowds, sick people and uncooked foods. They should never clean up after their pets, and they should ensure that their homes are kept clean. Food preparation surfaces should be sanitized and foods carefully selected and cooked thoroughly. Perhaps one of the most important rules to observe is diligent hand washing practices.

Long-Term Recovery and Follow-up
The five-year mark is a threshold that many medical professionals have selected as an indicator of disease-free survival. Transplant recipients should follow the guidance of their local physicians as well as the transplant center. Reasonable follow-up practices include repeat bone marrow biopsies, routine blood work, and any other special testing that may be necessary. Many tests include cytogenetic analyses to identify chromosomal abnormalities, FISH studies (fluorescent in-situ hybridization) to determine level of engraftment, and other DNA-based testing by a technique know as PCR (polymerase chain reaction). As time goes on, the frequency of these tests will diminish. It is important to use common sense and always seek the care of a medical professional if any unusual symptoms arise. Many patients report that it can be difficult to return to “normal life” after a bone marrow transplant. This is not all that unusual. However, it is important that transplant recipients take advantage of the second chance that they have been given, avoid excessive stress, take care of themselves physically and emotionally, and most of all - enjoy life!