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When to Consider Transplant

Many diseases that can be treated with a bone marrow or cord blood transplant (also called a BMT) change over time. For example, leukemia may change from a chronic phase to blast crisis or may be in remission after treatment. In some of these disease states, transplant may be a good treatment option. At other times, other treatments are better options. The better treatment option also depends on your individual risk factors, such as signs that your disease is likely to return and whether you have other health problems, such as heart disease. Some of these risk factors may change over time. For example, some chemotherapy treatments could damage your lungs, creating a risk factor you did not have earlier.

Both your risk factors and the state of your disease at the time of transplant can affect how well you do after transplant. In general, patients tend to have better results if they get a transplant:

Early in the process of the disease
When the disease is in remission or there is very little disease in the body
When the disease is sensitive to chemotherapy
When they are in good overall health and their organs work well

Seeing a transplant doctor

If a transplant may be an option for you, it is a good idea to see a transplant doctor (have a consultation) early after your diagnosis. A transplant doctor can work with your doctor to recommend the best time for a possible transplant. Your first treatment may not be a transplant, but a transplant doctor can help you and your doctor look at all your treatment options and plan ahead.

Finding a transplant doctor

Your doctor will probably recommend a transplant center for you. You may also want to check with your insurance plan for a list of transplant centers that your plan includes. If you will need an unrelated donor or cord blood unit, you will need to go to a transplant center that does unrelated transplants — some centers do only autologous transplants (using the patient's own cells) or transplants using family donors. For more information, see Choosing a Transplant Center.

Planning ahead

Planning ahead for the possibility of a transplant can make a difference:

Sometimes when patients relapse, they need a transplant quickly. It can take time to select a donor or cord blood unit for transplant. Taking the first steps of the donor search early may improve your chances of getting a quick transplant if you need one.
Some treatments you might get before a transplant could damage your heart, kidneys, lungs or liver. This organ damage can affect how well you do after a transplant. If you may need a transplant later, your doctor can discuss your treatment plan with a transplant doctor to avoid some of this damage.

Talking with your doctor about transplant

You may never need a transplant. However, planning ahead can make a difference if you do need one. You may want to talk to your doctor about where a possible transplant fits into your treatment plan. Questions you might ask include:

Will a transplant be an option at some point in my treatment?
When would a transplant become an option?
Should I see a transplant doctor now? If not now, when will you refer me to a transplant doctor?

You may find the National Marrow Donor Program's (NMDP) MatchView^SM a helpful resource when you talk with your doctor. You can use MatchView to see how many potential donors or cord blood units you may have on the NMDP Registry.

You may also want more in-depth information to help you talk with your doctor. Your doctor may want more information as well. You can find information to share with your doctor in the Physician Resources section of this Web site:

When to Consider Transplant

Seeing a transplant doctor

Planning ahead

Talking with your doctor about transplant

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