What to Expect During Your Inpatient Allogeneic Stem Cell Transplant


This video will help you know what to expect during your hospital stay for your allogeneic stem cell transplant at MSK.

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This video will help you know what to expect during your hospital stay for your allogeneic stem cell transplant at Memorial Sloan Kettering.

You may want to have a piece of paper and a pen handy while you watch this video so you can write down your questions. You can send your questions to your healthcare provider through MyMSK, call their office, or bring them to your next appointment.

On the day of your admission, you’ll first check in at the Admitting Office. It’s located on your right as you come in MSK’s main entrance at 1275 York Avenue.

Everyone having a stem cell transplant needs a central venous catheter, also called a CVC or Hickman catheter. A CVC is a tube that’s put into a large vein in your upper chest. Your CVC will let your care team draw your blood and give you medications, fl­uids, chemotherapy, and blood transfusions without sticking you with a needle multiple times. It’ll also be used to infuse your stem cells. Having a CVC will make your treatment much more comfortable.

One of your healthcare providers will give you a written resource with more information about CVCs and the CVC placement procedure. You can also find information on our website by going to www.mskcc.org/pe and searching “CVC.”

Most people have their CVC placed the day they’re admitted to the hospital. If this is true for you, after you check in at the Admitting Office you’ll go to the Center for Image-Guided Interventions for your CVC placement procedure. Take the M elevator to the 2nd ­floor and check in at the front desk.

You’ll probably need to wait a little while so your care team can make sure you’re ready for your procedure. The procedure itself only takes about 30 minutes. You’ll be sedated so you’re relaxed and don’t feel discomfort. After the sedation has worn off, a patient escort will bring you to your hospital room on M7 or M8.

During your hospital stay, you’ll have a private room with a bathroom for your use only. You’ll have a little while to get settled once you arrive. You can wear the hospital gown we give you or change into your own loose-fitting clothing.

Your care team will take a complete medical history, review your current medications, do a physical exam, and review the treatment calendar you got during your last visit before your admission. They’ll also attach your CVC to IV pumps. It will stay connected for most of your hospital stay.

Then, usually the day or evening you’re admitted, you’ll start the conditioning phase of your treatment. During your conditioning, you’ll get chemotherapy to suppress your immune system and make room in your bone marrow for your donor’s stem cells. Some people have radiation therapy as well.

Your conditioning may cause side effects, such as appetite loss, nausea, diarrhea rashes, or fatigue. The specific side effects you have depends on your treatment plan. Your care team knows how to manage each of these side effects and can help you feel more comfortable. Tell them about any side effects you’re having, if anything feels different, or if you have any pain so they can help you.

During and after your conditioning, you’ll be at high risk for infections. You’ll be able to have visitors, but no one who’s sick or thinks they might be sick should visit.

To help protect you from infections, the door to your room will be kept closed, but you’ll have a call bell to reach out to your healthcare team anytime you need. Everyone who goes into your room will have to wash their hands and wear a mask and gloves. These steps to protect you from infections are called isolation precautions. The door to your room will have a sign with the isolation precaution instructions visitors and staff need to follow. Your care team will also monitor you carefully so if you do get an infection, we can treat it right away.

On the day of your transplant, your care team will bring your stem cells to your room. They’ll check and sign off that the stem cells belong to you. Then, the stem cells will be infused into your bloodstream through your CVC. Your nurse will come in often to check on you and monitor your vital signs during your infusion.

Starting the day of your transplant or shortly after, your blood counts will be lower than normal, so you may have a fever, feel very tired, or have mouth sores. The side effects from your conditioning treatments may also linger during this time.

Your care team will take a sample of your blood every day to check how your white blood cells, red blood cells, and platelets are recovering. It’s normal for your blood counts to be lower than normal for about 10 to 14 days, or sometimes up to 21 days. When your blood counts are low, you may get blood or platelet transfusions.

If you have a fever, your care team will take extra blood samples from your CVC and a vein in your arm. They'll check the samples for signs of an infection in your CVC or bloodstream.

Every day, a member of your care team will check your weight, and a patient care technician will come to your room to help you shower. They’ll work with you to schedule your shower time.

You'll shower with a 4% chlorhexidine gluconate solution antiseptic skin cleanser such as Hibiclens. Chlorhexidine gluconate, also called CHG, kills bacteria on your skin to help protect you from infection. Your patient care technician will also wipe your skin and CVC lines with 4% CHG clothes after your shower.

It’s important to practice good mouth care after your transplant. You’ll need to rinse your mouth before and after meals and at bedtime. A member of your care team will give you a special alcohol-free mouthwash to use so your mouth doesn’t get irritated.

You’ll brush your teeth with an ultra-soft toothbrush and a store-bought toothpaste, but don’t use dental ­floss during this time. You’ll also need to moisturize your lips with a product like Burt’s Bees, ChapStick, or A&D ointment after you rinse your mouth and every 2 to 4 hours as needed. It’s important to keep your lips moist because if your mouth gets dry or cracks, these openings can provide access for germs.

Although you may feel tired, it’s important to get out of bed and stay active every day. Always ask for help when getting up from your bed or chair.

A physical therapist will teach you activities and exercises you can do. An occupational therapist will help you get back to doing your usual daily activities on your own. They'll also help you keep your mind active.

Walking around the unit is a great way to stay active. Your nurse or physical therapist will let you know when you can do this. If you need to stay in your room because you have an infection, you can still get out of your bed and do exercises in your room.

Your care team will plan your diet. You’ll get a menu and instructions on how to order your meals. If you'd like help choosing which foods to order, ask to meet with a clinical dietitian nutritionist. Room service will deliver your meals to you.

It's important to measure your food and drink intake and urine and stool output while you're in the hospital. Your care team will tell you how. We know it might feel gross or embarrassing, but it will help us plan your care.

Once your white blood cells begin to recover, your care team will work with you and your caregiver to plan your discharge. Over the course of a few days, your care team will teach you how to care for your CVC, handle and cook foods safely, and take other steps to protect yourself from infections. They'll make sure you understand how to care for yourself at home before you're discharged.

Before you go home, you’ll need to be eating a minimum number of calories, drinking 2 liters of liquids a day, and be able to take all your medications by mouth. These are things you’ll need to do where you’re staying after discharge. On average people can be discharged about 3 to 4 weeks after their transplant.

After discharge, you’ll need to stay within 1 hour of MSK for 100 days after your transplant. You’ll have appointments at the David H. Koch Center for Cancer Care at Memorial Sloan Kettering Cancer Center 2 or more times per week. You’ll also need to have a caregiver who will be with you 24 hours a day, 7 days a week during this time.

For more information about what to expect after discharge, visit our website at www.mskcc.org/pe and search “allogeneic stem cell.” If you have any questions, contact your healthcare provider. You can reach them by sending them a message through MyMSK or by calling their office.

Last Updated

Friday, April 29, 2022

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