Always follow the advice of your care team.
Clinical Preparations
This section explains important steps you will take as you prepare for transplant including:
Pre-Transplant Testing
Before your stem cell transplant, you will have a pre-transplant evaluation. This includes tests conducted over 1-2 days to check your organ function and to see if you are a good fit for stem cell transplantation. Testing often includes:
The amount of testing mainly depends on two factors:
Your transplant clinical coordinator will work with the rest of your care team to schedule your required pre-transplant testing. They will give you a schedule with all of your testing dates. This testing is usually done at the main Longwood campus of Dana-Farber or BWH.
Pre-Transplant Consultation Appointments
During the testing period, you will meet with your pre-transplant team.
A number of factors may impact your scheduled transplant date, including:
Your oncology nurse navigator will tell you about any changes to your scheduled transplant date.
Tips for Pre-Transplant Consult Appointments:
Meet with Your Clinical Social Worker
If you’ve been treated at Dana-Farber prior to transplant, then you may already be working with a clinical social worker. If you are new to our program, you will meet with a clinical social worker as part of your planning and preparation. They will meet with you and your caregiver in person or by phone.
This initial meeting provides an opportunity to learn more about you and your family and to discuss and explore issues such as:
If you would like to meet with a clinical social worker before your pre-transplant testing, request a referral from your care team.
If you are admitted to the hospital for your transplant, you will meet with a different clinical social worker while you are in the hospital. However, both of your clinical social workers will communicate with each other and with you during your transplant process to help provide the best care for you and your family.
Your Central Line Catheter (Tunneled Central Venous Catheter)
You will need to have a tunneled central line catheter(s) in place for your transplant. This provides access to your veins during the stem cell collection and stem cell transplant. It will also be used to take daily blood tests and give you intravenous (IV) medications and/or blood products (including your stem cell infusion).
Your catheter will be inserted surgically by placing one central venous line (a thin, flexible plastic tube) into a vein in your upper body (neck and chest) area.
The timing of your central line placement and where on your upper body it will be inserted depend on:
IMPORTANT: If your central line catheter was inserted by another facility:
We will not be to use your central line until we have confirmation of placement from the facility that inserted your line.
Online Resources: Getting and Caring for Your Central Line
Living with Your Central Line Catheter (PDF)
Flushing Your Central Line Catheter (PDF)
Fertility Considerations
Chemotherapy treatments may damage reproductive cells and cause temporary or permanent infertility. Menstrual periods may stop as a symptom of early menopause and sperm production may decrease. These side effects are related to a number of factors including your gender (sex assigned at birth), age, the specific type and dose of chemotherapy, the use of single therapy or many therapies, and the length of time since treatment.
If you are concerned about the effects of treatment on your ability to have children, discuss this with your care team before your stem cell transplant treatment begins.
Your transplant physician can recommend a fertility specialist who can discuss available options and help you (and your partner) through the decision-making process. Some of the options you may want to consider are sperm banking, artificial insemination, and in vitro fertilization.
There are resources available regarding infertility and cancer treatment. If you are interested, please contact:
Brigham and Women’s Hospital Center for Reproductive Medicine
617-732-4222
www.brighamandwomens.org/reproductivemedicine
FertileHOPE—fertility resources for cancer patients
888-994-HOPE (4673)
www.fertilehope.org
The American Society for Reproductive Medicine
205-978-5000
www.asrm.org
Protect Your Health as You Prepare for Transplant
During the stem cell transplant process, your immune function will be eliminated so that even the common cold could present a serious risk. So, maintaining a healthy lifestyle before you start the process gives you a better starting point.
There are many health behaviors that can help you prepare for your stem cell transplant.
Please refer to the comprehensive guide - Stem Cell Transplantation: An Information Guide for Patients and Caregivers for more information.
More information about getting and caring for your central line is on the Dana-Farber website.
- Pre-transplant testing
- Pre-transplant consultation appointments
- Meet with your clinical social worker
- Central line placement
- Fertility considerations
- Protect your health as you prepare for transplant
Pre-Transplant Testing
Before your stem cell transplant, you will have a pre-transplant evaluation. This includes tests conducted over 1-2 days to check your organ function and to see if you are a good fit for stem cell transplantation. Testing often includes:
- Lab tests and blood work
- Pulmonary function tests
- Electrocardiogram (EKG)
- Chest x-ray
- Multiple gated acquisition scan (a heart study often called muga)
- Echocardiogram
The amount of testing mainly depends on two factors:
- Requirements established by your insurance carrier
- Your transplant start date: There are requirements for when each test must be completed based on your transplant start date. Your clinical coordinator will schedule your tests to meet these requirements. You may also have specific testing requirements if you elect to participate in a clinical trial.
Your transplant clinical coordinator will work with the rest of your care team to schedule your required pre-transplant testing. They will give you a schedule with all of your testing dates. This testing is usually done at the main Longwood campus of Dana-Farber or BWH.
Pre-Transplant Consultation Appointments
During the testing period, you will meet with your pre-transplant team.
- Your oncology nurse navigator will provide stem cell transplant education.
- Your transplant clinical social worker will provide information and support depending on your needs.
- Your transplant physician will answer your questions and present you with the transplant consent forms which you both will sign. You will receive a copy of the transplant protocol or the treatment plan consents that you and your care team will follow.
- At the meeting with your physician, you may get a tentative date for your stem cell transplant. You may change your mind about the transplant at any time before you begin the transplant conditioning.
A number of factors may impact your scheduled transplant date, including:
- Insurance approval
- Testing results
- Any changes to your health
- Changes in donor availability
Your oncology nurse navigator will tell you about any changes to your scheduled transplant date.
Tips for Pre-Transplant Consult Appointments:
- Bring your caregiver. They can be helpful by asking questions, taking notes, and being a second person listening to the discussion.
- Ask questions.
- Ask for explanations about anything you do not understand.
- Prepare questions in advance and take notes or record the answers as you hear them.
- Follow up with your oncology nurse navigator if you think of questions after your appointment.
Meet with Your Clinical Social Worker
If you’ve been treated at Dana-Farber prior to transplant, then you may already be working with a clinical social worker. If you are new to our program, you will meet with a clinical social worker as part of your planning and preparation. They will meet with you and your caregiver in person or by phone.
This initial meeting provides an opportunity to learn more about you and your family and to discuss and explore issues such as:
- Your understanding of the transplant process
- Your caregiver’s role during and after transplant
- Communicating with children in your life, understanding their adjustment, and learning how to help them during your stem cell transplant
- Coping with the emotional impact of transplant and the recovery period
- Finding positive approaches to coping with the challenges of stem cell transplant
- Understanding and planning for the impact of the transplant process on your and your family’s life
- Identifying support resources at Dana-Farber and in your community
- Understanding a health care proxy form and advance directives
- Spiritual resources and integrative therapies
If you would like to meet with a clinical social worker before your pre-transplant testing, request a referral from your care team.
If you are admitted to the hospital for your transplant, you will meet with a different clinical social worker while you are in the hospital. However, both of your clinical social workers will communicate with each other and with you during your transplant process to help provide the best care for you and your family.
Your Central Line Catheter (Tunneled Central Venous Catheter)
You will need to have a tunneled central line catheter(s) in place for your transplant. This provides access to your veins during the stem cell collection and stem cell transplant. It will also be used to take daily blood tests and give you intravenous (IV) medications and/or blood products (including your stem cell infusion).
Your catheter will be inserted surgically by placing one central venous line (a thin, flexible plastic tube) into a vein in your upper body (neck and chest) area.
The timing of your central line placement and where on your upper body it will be inserted depend on:
- Type of treatment
- Prior history of having a central venous catheter,
- Past medical or surgical history (e.g. a pacemaker) that may be important in planning your procedure
IMPORTANT: If your central line catheter was inserted by another facility:
- Ask the physician who placed it to send a written report to Dana-Farber documenting the placement of the catheter. This report will likely be a chest x-ray, indicating the position/location of the catheter tip in the vein.
- Your doctor can fax the report to 857-215-0245.
We will not be to use your central line until we have confirmation of placement from the facility that inserted your line.
Online Resources: Getting and Caring for Your Central Line
Living with Your Central Line Catheter (PDF)
Flushing Your Central Line Catheter (PDF)
Fertility Considerations
Chemotherapy treatments may damage reproductive cells and cause temporary or permanent infertility. Menstrual periods may stop as a symptom of early menopause and sperm production may decrease. These side effects are related to a number of factors including your gender (sex assigned at birth), age, the specific type and dose of chemotherapy, the use of single therapy or many therapies, and the length of time since treatment.
If you are concerned about the effects of treatment on your ability to have children, discuss this with your care team before your stem cell transplant treatment begins.
Your transplant physician can recommend a fertility specialist who can discuss available options and help you (and your partner) through the decision-making process. Some of the options you may want to consider are sperm banking, artificial insemination, and in vitro fertilization.
There are resources available regarding infertility and cancer treatment. If you are interested, please contact:
Brigham and Women’s Hospital Center for Reproductive Medicine
617-732-4222
www.brighamandwomens.org/reproductivemedicine
FertileHOPE—fertility resources for cancer patients
888-994-HOPE (4673)
www.fertilehope.org
The American Society for Reproductive Medicine
205-978-5000
www.asrm.org
Protect Your Health as You Prepare for Transplant
During the stem cell transplant process, your immune function will be eliminated so that even the common cold could present a serious risk. So, maintaining a healthy lifestyle before you start the process gives you a better starting point.
There are many health behaviors that can help you prepare for your stem cell transplant.
- Remain physically active. Aim for at least 30 minutes of activity each day. This can be:
- Walking
- Low impact exercise activity (such as golfing, swimming, stretching)
- Riding a stationary bike
- Engaging in integrative therapies (such as massage, reiki, yoga, or tai chi).
- If you are a smoker, we recommend that you stop smoking immediately. This includes smoking and vaping any products including nicotine or marijuana, which poses a risk of fungal infection. Be sure to tell your doctor about any previous or current smoking habits. They can help you establish an appropriate cessation program.
- ONE WEEK BEFORE TRANSPLANT: Do not take aspirin, medications that contain aspirin, or other non-steroidal anti-inflammatory medications (NSAIDs), such as ibuprofen because these medicines will interfere with blood clotting functions.
- TWO WEEKS BEFORE TRANSPLANT: Do not drink any alcohol (including beer and wine). This is important because alcohol interferes with the liver’s ability to process chemotherapy in your body.
- Discuss with your care team if/when you should trim your fingernails and toenails. You will not be able to do for a period of time during and after transplant because it could put you at risk of infection or bleeding.
Please refer to the comprehensive guide - Stem Cell Transplantation: An Information Guide for Patients and Caregivers for more information.
More information about getting and caring for your central line is on the Dana-Farber website.