Bone Marrow and Blood Stem Cell Transplants: A Guide for Patients

by Susan K. Stewart

Chief Medical Advisors: Patrick J. Stiff MD, Martin S. Tallman MD
Illustrator: Norm Bendell

A comprehensive and easy-to-read book that's a "must" for patients considering a transplant using donor bone marrow, blood stem cells or cord blood. The book walks the reader through what to expect before, during and after transplant and includes the perspective of patients and caregivers as well.

"This book is an essential part of my educational efforts with patients and their families. It explains in an understandable, but non-patronizing, way the rationale and procedures for bone marrow and blood stem cell transplantation. Covering a broad range of topics, it is a real gift for people who must quickly learn a complicated topic, as they struggle to cope with the stresses of a life-threatening illness."

Mary M. Horowitz MD MS
Scientific Director, Center for Blood & Marrow Transplant Research

Chapters include

History of Transplantation
A historical perspective and look into the future of the uses of bone marrow, peripheral blood stem cell and cord blood transplants.

Nuts and Bolts of a Transplant
A comprehensive overview of the stem cell transplantation, including a clear explanation of the differences between bone marrow and peripheral blood stem cell transplants and a narration of post-transplant issues.

Choosing a Transplant Center
A detailed description of key things to look for when choosing a transplant center, including how to interpret "success rates".

Finding a Stem Cell Donor
Some patients are fortunate enough to have a family member who is a suitable stem cell donor. Others must search for an unrelated donor. This chapter explains how the search is conducted, and explains the tests used to determine whether a patient and donor are a match.

Being a Donor
In the rush to help the patient who has a serious illness, the questions and concerns of the donor are sometimes overlooked. This chapter describes what's involved in donating bone marrow or peripheral blood stem cellsCells that can replicate themselves or evolve into different types of blood cells, and shares insights from other donors about emotional challenges that donors often face.

Emotional and Psychological Considerations
Many things come into play with news of a transplant. In this chapter you'll find help with getting information, putting things into perspective, dealing with the sense of loss of control, coping with stress, accessing support services, keeping in touch with friends, and getting back to normal.

When Your Child Needs a Transplant
A guide for families on the array of issues facing them when a child needs a transplant including involving the child in decision-making, questions children ask, anxiety, life during transplant, loss of control, preparing children for medical procedures, siblings' care, marital stress, going home, and getting back to normal.

Preparative RegimenThe treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A preparative regimen may include chemotherapy, monoclonal antibody therapy, and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow, helps prevent the patient's body from rejecting the transplanted cells, and helps kill any cancer cells that are in the body. Also called conditioning regimen.
The high-dose combination chemotherapyDrug or combination of drugs designed to kill cancerous cells. that comprises the preparative regimen frightens many people. This chapter addresses the short- and long-term side effects of the preparative regimen and puts them in perspective.

GraftHealthy blood forming stem cells used to replace a patient's diseased blood forming stem cells-versus-Host Disease
Graft-versus-Host disease is often a complication of a stem cell transplant. This chapter explains the differences between acuteHaving severe symptoms and a short duration. and chronicPersisting for a long time. graft-versus-host disease, and steps taken to prevent and treat them.

Infection
A detailed description of, and remedies for, the types of infections that can occur after transplant.

Liver Complications
A clear explanation of the short- and long-term effects to the liver that may happen as a result of treatment.

Nutrition
A detailed description of nutritional problems that can occur after treatment, with concrete suggestions for overcoming them.

Relieving Pain
A thorough discussion of an array of pharmaceutical and non-drug pain relief techniques.

Caregiving
A caregiver's role is one of the most important yet least explored in the transplant process. This chapter has those who have done it discuss candidly such things as taking time to recharge, accepting help, being the patient's advocate, flexibility and patience, keeping a sense of humor, relaying information to others, changing relationships, and helping children cope.

Long-Term Survivors: What Lies Ahead
What's in the future for a survivor of a transplant? You'll hear from long-term survivors about such very real issues as quality of life, fear of relapseRecurrence of the disease following treatment., physical health, fatigue, cognitive changes, sexuality, re-vaccination, emotional wellbeing; hepatitisDisease of the liver causing inflammation which can lead to scarring of the liver. C, cataracts, spouses and children, working and spirituality.

Sexuality and Reproduction
The impact of a transplant on sexuality and reproduction are issues that are often not talked about. This chapter offers a candid discussion about sexuality and the options available for having children after transplant.

Insurance and Fundraising
An extremely helpful chapter that discusses financial options available to transplant patients including how to handle a denial of insurance coverage, tapping into benefits available from life insurance policies, viatical settlements and how to find organizations that provide financial assistance.