In the Spotlight
Bone Marrow Transplantation
By Linda L. Cook, RN, BSN, Clinical Transplant Coordinator VA Puget Sound Health Care System, Seattle, WA
Your healthcare provider told you that you need a bone marrow transplant. Your mind is spinning in a dozen different directions. What do you do now? The good news is that the VA has a well-established and highly regarded marrow transplant program. Transplants have been performed in the VA system since 1982, when the first center opened in Seattle. San Antonio and Nashville have since joined the transplant program. If you are a veteran, you are eligible for evaluation for treatment at one of those locations.
In these three centers, bone marrow transplants are offered to veterans diagnosed with leukemia, lymphomas, multiple myeloma and many other "blood cancers." You will first receive tests and procedures at your home Department of Veterans Affairs Medical Center (VAMC). The tests help determine the stage of your disease and your general state of health. Those results, along with a formal referral from your healthcare provider, are sent to the VA National Transplant Program office in Washington DC. At least two transplant healthcare providers review the referral packet to determine if a transplant is the best choice for you. It usually takes several weeks for your home VAMC to get all the tests and referral information sent to the national office. The evaluation of your referral takes another couple weeks. Then your healthcare provider is notified of the decision and will contact you. The specific transplant center then sends you a letter confirming that you have been approved for an evaluation. This letter gives you contact information for people at that site who can answer your questions. Your disease and the type of transplant you need determine where you will receive treatment. It is possible that the site selected for you is not the one closest to your home. The location is chosen so that you receive the best possible care for your illness.
Important things to remember: The referral process gets you to one of the transplant centers for an on¿site evaluation. That is where the final decision about transplantation is made. Until you actually arrive at the transplant center, your home VAMC healthcare provider is in charge of your care.
Once the transplant center knows to schedule your evaluation, they will contact you. The center will send you information about the program, and what you can expect during your stay. You need to identify a responsible adult (caregiver) who can be with you throughout your stay. Your caregiver is needed to provide non¿medical support for you. You will be in the hospital for part of your stay. In most cases, the greater amount of time is spent as an outpatient. Your caregiver will help you get to the center for appointments and assist with daily chores. All three of the VA transplant centers provide housing for patients and their caregivers. The transplant center provides you with information about housing. This information can help you decide what things you should bring with you to make your stay more comfortable.
VA pays round trip airfare for the patient, caregiver, and living donor. Additional people may stay in the apartment, but they need to pay for their own transportation and lodging. Other costs not covered by VA are food and incidental expenses. Depending on the type of transplant you have, you and your caregiver may be required to stay at the transplant center for several months. We realize this is a big commitment. Each center has dedicated staff available to help you at each stage leading up to transplant.
Bone Marrow Transplantation (Medline Plus)
Trasplante de médula ósea (Medline Plus) (en Español)
Patient Frequently Asked Questions (National Marrow Donor Program)
Updated/Reviewed: December 30, 2008