What Conditioning Before a Stem Cell Transplant Does and How Those Days Are Planned

The admission letter arrives with a calendar attached, and the numbers on it run backward. Day minus seven. Day minus six. Somewhere near the bottom sits a single line marked Day 0, circled, with the word “infusion” beside it. For most people the strangest part is not the transplant itself but the week before it, when the treatment they have been told about for months finally has a start time.

That week is conditioning before stem cell transplant, and it is where the real work of the procedure begins. The infusion on Day 0 takes about as long as a blood transfusion. The conditioning that precedes it is what makes that infusion meaningful, and it is also the part that shapes how the following month feels.

This explainer walks through what those days are for, how teams choose between gentler and stronger approaches, what commonly happens on the ward, and which questions are worth asking before the first bag is hung.

What does conditioning before stem cell transplant actually do?

A stem cell transplant replaces the blood-forming system. Hematopoietic stem cells, the immature cells in the bone marrow that produce red cells, white cells and platelets, are collected from a donor or from the patient earlier, then infused through a vein. Conditioning is the treatment given in the days immediately before that infusion, and it usually has three jobs at once.

The first is anti-disease work. In leukemia, lymphoma or myeloma, conditioning delivers chemotherapy, sometimes with radiation, at a strength intended to remove as much residual disease as possible. The second is making room. Bone marrow is a busy space, and the existing cells occupy the niches the new cells need; clearing some of that population helps the graft take hold. The third, which matters most when the cells come from another person, is immune suppression. A healthy immune system recognizes donor cells as foreign and would reject them. Conditioning weakens that response long enough for the graft to establish itself.

How much of each job a regimen does depends on its design. Autologous transplants, where a person receives their own previously collected cells, need no anti-rejection effect at all, so conditioning there is essentially high-strength chemotherapy that the stored cells later rescue the marrow from. Allogeneic transplants, using a donor, need all three effects in some balance.

One idea helps make sense of the rest of this article: conditioning is not a single drug or a single day. It is a scheduled sequence, planned so that the treatment’s effect on the marrow is at its deepest right as the new cells arrive, and so that the medicines have cleared from the body enough that they do not harm those cells on arrival. The rest day some schedules include before Day 0 exists for exactly that reason.

How long is conditioning for stem cell transplant?

Most conditioning schedules run for several days up to about a week, occasionally slightly longer, with the infusion following on Day 0. Transplant teams write the plan as negative numbers counting down to that day, so a regimen might start on Day minus 6 or Day minus 7. Patient information from the NHS and Mayo Clinic describes conditioning in these terms, as a treatment period lasting days rather than weeks, followed by the infusion and then a much longer recovery.

The shape of the countdown varies. Some regimens front-load chemotherapy on the first days and finish with an immune-suppressing agent close to Day 0. Others alternate chemotherapy and radiation sessions. Many include one drug-free day right before infusion so that chemotherapy levels fall before the new cells arrive.

It helps to think of three nested timelines rather than one:

• The conditioning window itself: typically about a week, per the NHS and Mayo Clinic descriptions.
• The hospital stay: the NHS notes people often remain in hospital for around one to three months after an allogeneic transplant, depending on how quickly counts recover and whether complications arise.
• Engraftment, the point at which the new cells begin producing measurable blood counts: MedlinePlus and NHS materials describe this as commonly taking two to four weeks after infusion.

These are typical ranges from public health sources, not promises. A person whose kidneys clear a particular drug slowly, or who develops an infection mid-week, may see the schedule stretch. The team will say on the first day what the planned calendar is, and it is entirely reasonable to ask them to write the day numbers out so the week is easier to track from the bed.

Myeloablative vs reduced intensity: what the intensity labels mean

Transplant physicians sort conditioning regimens by how completely they wipe out the existing marrow. A working definition published by an international group of transplant researchers in 2009, indexed on PubMed, remains the common reference. It describes three tiers based on what happens to blood counts and whether the marrow could recover on its own without infused cells.

Tier	Effect on the marrow	Would the marrow recover without infused cells?	Typical role of the graft
Myeloablative	Profound, expected to be irreversible fall in blood counts	No; stem cell rescue is required	Restores blood production and, in donor transplants, provides immune effect against disease
Reduced intensity	Substantial but incomplete fall in counts	Uncertain; recovery would be slow and unreliable	Relies more on the donor immune system to control disease over time
Nonmyeloablative	Minimal fall in counts	Yes, typically	Mainly suppresses the recipient’s immunity so donor cells can engraft and act

The word myeloablative combines myelo, meaning marrow, with ablative, meaning to remove. A myeloablative regimen aims for maximum anti-disease effect and depends entirely on the infused cells for survival of the blood system. Reduced intensity and nonmyeloablative regimens deliberately do less damage to the marrow and lean on a different mechanism: once donor immune cells engraft, they can recognize and attack residual disease, an effect known as graft-versus-tumor.

Neither approach is universally better. Stronger conditioning carries more organ toxicity and a heavier early course. Gentler conditioning is easier to tolerate but asks the donor immune system to do more of the disease control, and the trade-offs between relapse and treatment-related complications differ by diagnosis and by the person. Deciding which tier fits is one of the central judgments the transplant team makes, and it is worth asking them to explain which tier they have chosen and why.

Who is reduced intensity conditioning usually for, and who is asked to wait?

Reduced intensity conditioning changed who could be offered a donor transplant. Before it existed, the toxicity of full-strength regimens effectively limited allogeneic transplants to younger, fitter people. Public information from Mayo Clinic and Johns Hopkins notes that reduced intensity approaches now allow older adults, and those with other health conditions such as heart, lung or kidney limitations, to be considered.

In practice, teams weigh several things together rather than applying an age cutoff. Organ function tests of the heart, lungs, liver and kidneys carry a lot of weight, because conditioning drugs and radiation stress those systems. A measure of how active the disease is at the time of transplant matters too, since myeloablative regimens are often favored where residual disease is a major concern and the person can tolerate them. Performance status, a clinician’s assessment of how someone manages daily activities, is another input. So is the donor type, because some donor combinations are paired with particular regimen designs.

Being asked to wait is common and is rarely a rejection. Typical reasons include:

• An active infection that needs to be controlled first, because conditioning removes the immune defenses that would fight it.
• Disease that is not yet in a state the team considers suitable for transplant, so more treatment is given beforehand.
• Organ function results that need to improve, for example fluid on the lungs or a heart measurement below the team’s threshold.
• A donor whose availability or medical clearance has shifted the timeline.

Occasionally the wait leads to a change of plan, for instance from a myeloablative to a reduced intensity regimen. That is a clinical decision built on the person’s own results, and the team is the right source for why it was made.

The workup weeks: what happens before the first conditioning day

Conditioning begins on paper long before the first infusion. The weeks beforehand are a checklist that the team works through, and knowing what is on it makes the appointments feel less scattered.

Organ testing comes first. An echocardiogram or similar scan checks how well the heart pumps. Lung function tests measure breathing capacity and how well oxygen crosses into the blood. Blood work assesses liver and kidney function and screens for viruses such as hepatitis, HIV and cytomegalovirus, a common virus that can reactivate when immunity is low. Dental review is standard, because a hidden tooth infection can become dangerous once white cells fall. Mayo Clinic and MedlinePlus both describe this pre-transplant evaluation as a routine phase of the process.

A central venous catheter is placed, usually a few days before admission. This is a soft tube inserted into a large vein in the chest or arm, with ports outside the skin, so that chemotherapy, fluids, antibiotics, blood products and the stem cells themselves can all be given without repeated needles. It stays in for weeks.

Fertility conversations belong in this window too. Many conditioning regimens damage the ovaries or testes, and options such as sperm or egg preservation need to happen before treatment starts. Anyone who might want children later should raise it early, and the team should raise it regardless.

There is also planning of a different kind: who will be the caregiver, where they will stay, how to reach the ward at night, what to pack for a stay measured in weeks. Social workers and transplant coordinators exist for these conversations. The clinical checklist gets the attention, but the practical one tends to decide how the month actually feels.

What a conditioning day looks like on the transplant ward

The rhythm of a conditioning day is more ordinary than most people expect. Morning bloods are drawn from the central line. A nurse checks weight, temperature, blood pressure and fluid balance; weight matters because some drugs are calculated from body size and because fluid retention is a known side effect. Anti-nausea medicines are given before chemotherapy, not after, because preventing nausea is easier than treating it.

The chemotherapy itself runs through the line over a set number of hours. Drugs used in conditioning include alkylating agents such as busulfan, cyclophosphamide and melphalan, which damage DNA in rapidly dividing cells, and purine analogs such as fludarabine, which mainly suppress lymphocytes, the immune cells responsible for rejection. Which are used, in what combination and for how many days, is set by the regimen the team has chosen. Some drugs require extra fluids or a protective agent to shield the bladder or other organs, so a day may involve a lot of time attached to a pump.

Total body irradiation, when it is part of the plan, is delivered in the radiation department, usually in short sessions once or twice daily over several days. The person lies or stands in a fixed position while the machine treats the whole body. It is painless in the moment; the effects show up later.

Serotherapy is the third tool. Anti-thymocyte globulin and certain monoclonal antibodies target the recipient’s T cells to reduce rejection and graft-versus-host disease. These infusions can cause fever, chills and rash while they run, so they are given slowly with premedication and close observation.

Between infusions there is time. Walking the corridor, doing the mouth care routine the nurses teach, eating when appetite allows: these small actions are part of the plan, not a distraction from it.

Conditioning chemotherapy side effects, and how the team plans around them

Conditioning side effects follow a fairly predictable order, and the team’s schedule of supportive care is built around that order. Knowing the sequence removes some of the dread.

Nausea and fatigue are the earliest, often within the first day or two. Modern anti-nausea regimens, scheduled rather than given on demand, have made this considerably more manageable than older accounts suggest, though it varies by person and by drug. Hair loss typically begins one to three weeks after the chemotherapy starts, which means it often happens after the infusion rather than during conditioning itself.

Mucositis, inflammation and ulceration of the lining of the mouth and gut, usually appears several days after conditioning ends and peaks in the week or so after Day 0. It can make swallowing painful and may require intravenous pain relief and nutrition. Mouth care, ice chips during certain infusions, and regular assessment are the standard defenses. Diarrhea often accompanies it as the gut lining is affected.

Low blood counts are the intended consequence, not a side effect in the usual sense, but they drive the most important risks. White cells fall to near zero within days, leaving the person vulnerable to infection; platelets fall, raising bleeding risk; red cells fall, causing tiredness and breathlessness. Transfusions and protective antibiotics, antivirals and antifungals are scheduled in anticipation.

Organ-specific effects depend on the regimen. Some alkylating agents can affect the liver, causing a condition called sinusoidal obstruction syndrome in which small liver blood vessels become blocked. Others can irritate the bladder or affect the heart. Radiation adds skin changes and, later, cataract and thyroid risks. The NHS and Mayo Clinic patient pages list these among the recognized complications, and the team monitors for each with daily blood tests and examination. Every effect described here should be reported as it happens, because early treatment is the single most reliable way to keep it small.

Where graft-versus-host disease prevention fits into the calendar

Graft-versus-host disease, usually shortened to GVHD, is the mirror image of rejection: the donor immune cells recognize the recipient’s body as foreign and attack it, most often the skin, gut and liver. Preventing it starts during conditioning, and understanding this explains several items on the calendar that are not chemotherapy against disease.

Immune-suppressing medicines aimed at GVHD prevention are typically started in the last days of conditioning or right around Day 0, so that they are already active when donor cells arrive. Calcineurin inhibitors, a class that dampens T cell activation, are a long-standing backbone and are usually continued for months afterward, with blood levels checked regularly. Antimetabolites such as methotrexate or mycophenolate are often added for a defined period after infusion.

Donor type shifts the plan. When the donor is a half-matched family member, known as a haploidentical donor, many teams give a dose of cyclophosphamide in the first days after infusion rather than only before it. The timing is deliberate: the drug preferentially removes the donor T cells that have just become activated against the recipient, while sparing the stem cells and the more quiescent immune cells. This approach broadened access to transplant for people without a fully matched donor, and it means the calendar for a haploidentical transplant has treatment days on the positive side of Day 0 as well as the negative.

Serotherapy given during conditioning, described earlier, also counts as GVHD prevention. So does the choice of graft source, since cells collected from peripheral blood contain more T cells than those collected directly from bone marrow.

None of this is optional detail. A person following their own schedule will see medicines starting at odd times, and asking “is this for the disease, for rejection, or for GVHD?” is a clear way to understand what each one is doing.

Day 0 and the weeks that follow

Day 0 is often quieter than people imagine. The stem cells arrive in one or more bags and are infused through the central line over minutes to a few hours, much like a transfusion. Nurses check vital signs frequently. If the cells were frozen, the preservative used in freezing can cause a distinctive taste and smell, sometimes described as garlic or creamed corn, and occasionally nausea or flushing. Fresh donor cells usually cause fewer immediate reactions. MedlinePlus and the NHS both describe the infusion as a straightforward procedure compared with what surrounds it.

Then comes the wait. The infused cells travel through the bloodstream to the marrow, a process called homing, and begin dividing. Nothing visible happens for days. Meanwhile the effects of conditioning reach their deepest point, so the first one to two weeks after Day 0 are typically the hardest, a period covered in more detail in the next section.

Engraftment is declared when the white cell count, specifically the neutrophil count, rises above a threshold on consecutive days. MedlinePlus and NHS materials describe this as commonly happening two to four weeks after infusion, though the source of cells and the regimen intensity influence the timing. Platelet recovery usually follows, sometimes weeks later.

Discharge from hospital depends on counts, on eating and drinking, on freedom from fever, and on having a caregiver and a home environment the team considers safe. The NHS describes hospital stays of around one to three months for allogeneic transplants. After discharge, clinic visits are frequent, often several times a week at first, with blood tests, medication adjustments and monitoring for infection and GVHD. Immune recovery in a fuller sense, including vaccination schedules being restarted, unfolds over months to a year or more, and the team will set that timeline individually.

What are the worst days after a stem cell transplant?

People searching this question want honesty, so here it is: for most, the most difficult stretch is roughly the first to second week after Day 0, when the full effect of conditioning has arrived and the new cells have not yet produced anything measurable. Clinicians sometimes call this the nadir, from the astronomical term for the lowest point.

Several things converge in that window. Mucositis is usually at its peak, making eating, drinking and even talking uncomfortable; intravenous nutrition and pain relief are common. Neutrophils are at or near zero, so any fever is treated as a possible bloodstream infection and prompts immediate cultures and antibiotics. Fatigue is profound, in a way that people who have had chemotherapy before often say is different in kind. Diarrhea, nausea and loss of taste can persist. Platelets need transfusing; red cells too. Sleep is broken by observations through the night.

Emotionally, this is also the low point for many. The room feels small. Visitors are restricted. The cells were infused days ago and nothing seems to be happening. Transplant nurses know this pattern well and tend to say the same thing: the silence is expected, and counts rarely rise before the second week.

The turn, when it comes, is often noticed as a small number on a morning blood result before it is felt. Once neutrophils return, fevers usually settle, the mouth begins to heal within days, and appetite creeps back. That said, later weeks bring their own challenges, particularly acute GVHD, which most often appears in the first hundred days after an allogeneic transplant, and viral reactivations as immunity slowly rebuilds. The worst days are real, they are usually time-limited, and describing them accurately beforehand is a kindness, not a warning meant to frighten.

What not to do before stem cell transplant conditioning starts

The pre-transplant instructions can feel like a long list of prohibitions. Most trace back to two principles: do not add infection risk, and do not introduce anything that could interfere with the planned medicines.

On infection, the logic is simple. Conditioning will remove the immune defenses that normally handle everyday exposures. So teams commonly ask people to avoid crowded indoor spaces and anyone with a cold or stomach bug in the days before admission, to complete dental work well ahead of time, and to report any new cough, sore throat or urinary symptoms immediately, even mild ones, because an infection discovered on Day minus 7 is far easier to treat than one discovered on Day plus 5.

On medicines and supplements, the essential instruction is to tell the team about everything being taken, including herbal products, vitamins, over-the-counter painkillers and anything bought online. Some supplements affect liver enzymes that process chemotherapy drugs; some over-the-counter products increase bleeding risk when platelets are low. This does not mean stopping anything on one’s own. The pharmacist and physician will review the list and decide what continues, pauses or changes, and that review is a routine part of the workup.

Other common instructions include:

• Following the food safety guidance the team provides, which usually emphasizes thoroughly cooked foods and careful handling rather than a rigid list.
• Avoiding alcohol in the run-up, since the liver will be processing conditioning drugs.
• Not getting live vaccines shortly beforehand; the team will say which vaccines, if any, are appropriate and when.
• Arranging fertility preservation before the first chemotherapy day if it is wanted.

Anything unclear on the instruction sheet deserves a phone call to the transplant coordinator. Vague guesses in this period tend to cost more than the two minutes it takes to ask.

What people often get wrong about conditioning

Myths gather around any treatment that combines fear and unfamiliar vocabulary. A few come up repeatedly.

“Reduced intensity means the team is giving up.” It does not. Reduced intensity regimens were developed so that people who could not tolerate myeloablative treatment could still receive a donor transplant, and they rely on a real biological mechanism, the donor immune system’s action against disease, rather than chemotherapy strength alone. The trade-offs are genuine and differ by diagnosis, which is exactly why the choice belongs to the team that knows the full picture.

“You can trigger stem cell regeneration yourself.” Searches for foods, supplements or exercises that boost stem cells are common. Mainstream evidence does not support any diet or supplement that speeds engraftment after transplant. What does influence recovery is the number and quality of cells infused, the regimen, and medical growth factors that some teams give after infusion to stimulate white cell production. Good nutrition, movement and sleep support the body during recovery, but they are not a switch that turns the marrow on.

“Conditioning is the transplant.” People often describe the whole month as “the transplant,” but the infusion is one short event; conditioning is the treatment before it, and recovery is the long phase after. Keeping the three separate makes the calendar easier to read.

“Once counts come back, the risky period is over.” Engraftment is a milestone, not a finish line. Acute GVHD, viral reactivations and late organ effects arrive afterward, which is why follow-up is intensive for months.

“Everyone gets radiation.” Total body irradiation is part of some regimens and absent from many. Its use depends on diagnosis, age, prior treatment and the team’s protocol, not on how serious the situation is.

Questions to ask your care team

Consultations before transplant cover a lot, and it is easy to leave with the big picture and none of the specifics. These questions are designed to pull out the details that shape the coming weeks. Writing the answers down, or having a caregiver do so, is worth the small awkwardness.

• Which conditioning regimen have you chosen for me, and is it myeloablative, reduced intensity or nonmyeloablative? What led you to that choice over the alternatives?
• Can you write out my day-by-day calendar, from the first conditioning day through Day 0, including any rest day and any treatment planned after infusion?
• Does my plan include total body irradiation or serotherapy? If so, what should I expect during those sessions?
• Which of the medicines on my schedule are against the disease, which are to prevent rejection, and which are to prevent GVHD? How long will each continue?
• What side effects do you expect in my case, in roughly what order, and what is already planned to prevent or treat each one?
• What is your threshold for delaying or changing the regimen once it has started, and who makes that call?
• How will I know engraftment has happened, and what is the typical range you see with this regimen and graft source?
• What are the criteria for going home, and what will the first weeks after discharge look like in terms of visits and tests?
• Who do I call, at any hour, if I develop a fever or new symptom, and what number should my caregiver keep?
• Are there fertility, dental or vaccination steps I need to complete before conditioning begins?

None of these are challenges to the team’s judgment. Transplant physicians generally welcome them, because a person who understands the plan notices problems earlier and describes them more clearly. The decisions remain with the treating team; the questions simply make sure both sides are reading the same calendar.

When to call your doctor

During conditioning and the weeks that follow, the rule is different from ordinary life: symptoms that would normally justify waiting a day should be reported the same hour. The immune system is not there to buy time, and the transplant team expects calls. Most units give a direct number that is answered around the clock, and nobody on the other end will consider a call unnecessary.

Contact the team immediately, or go to the emergency department if instructed, for any of the following:

• A temperature of 38°C (100.4°F) or higher, or feeling shivery and unwell even without a measured fever, since fever with very low white cells is treated as a medical emergency.
• New breathlessness, chest pain, a fast heartbeat or a cough that is worsening.
• Bleeding that does not stop, blood in urine or stool, black stools, or widespread small bruises or pinpoint red spots on the skin.
• Severe or persistent vomiting or diarrhea, inability to keep fluids down, or signs of dehydration such as dizziness on standing and very little urine.
• A new rash, especially on the palms, soles or trunk, or yellowing of the skin or eyes, both of which can signal GVHD or liver involvement.
• Redness, swelling, pain or discharge at the central line site, or a fever shortly after the line is flushed.
• Confusion, severe headache, unusual drowsiness, a seizure, or sudden weakness or difficulty speaking.
• Rapid weight gain, swelling of the legs or abdomen, or pain under the right ribs.

Caregivers should know this list as well as the person receiving treatment, because fatigue and medication can make it hard to judge one’s own symptoms. When in doubt, call. The team would far rather hear about a symptom that turns out to be minor than learn about a serious one late, and every decision about what to do next belongs with them.

Frequently asked questions

How long is conditioning for stem cell transplant?

Conditioning usually lasts several days to about a week, ending the day before the stem cell infusion on Day 0. The NHS and Mayo Clinic describe it as a treatment period measured in days, followed by a recovery phase measured in weeks. The exact number of days depends on the regimen chosen, whether radiation is included, and whether a rest day is scheduled before infusion. Your team will give you a written day-by-day calendar.

What is the difference between myeloablative vs reduced intensity conditioning?

Myeloablative conditioning suppresses the bone marrow so profoundly that it cannot recover without infused stem cells, while reduced intensity conditioning causes a substantial but incomplete fall in counts and leans more on the donor immune system to control disease. A 2009 working definition indexed on PubMed set out these tiers, with nonmyeloablative regimens as the gentlest category. The choice depends on diagnosis, age, organ function and donor type.

Is reduced intensity conditioning less effective?

Not in a simple sense. Reduced intensity regimens trade lower early toxicity for greater reliance on the graft-versus-tumor effect, in which donor immune cells attack residual disease over time. Relapse and complication risks differ by diagnosis and by the individual, so no single answer applies to everyone. Public sources such as Mayo Clinic note that these regimens expanded transplant access to older and less fit adults. Your team can explain how the trade-offs apply to you.

What are the worst days after a stem cell transplant?

For most people, the most difficult period is roughly the first one to two weeks after infusion, when white cells are near zero, mouth and gut inflammation peak, fatigue is profound and fevers are common. This low point, sometimes called the nadir, usually eases once engraftment begins, which MedlinePlus and the NHS describe as commonly occurring two to four weeks after infusion. Later weeks can still bring GVHD and infections, so follow-up remains close.

What not to do before stem cell therapy?

Avoid anything that raises infection risk or could interfere with planned medicines. That commonly means steering clear of crowded indoor spaces and unwell contacts, completing dental work early, avoiding alcohol, not receiving live vaccines without team approval, and reporting every supplement, herbal product and over-the-counter medicine you use. Do not stop or start anything on your own; the transplant pharmacist and physician will review your list and decide what continues or pauses.

How to trigger stem cell regeneration after conditioning?

There is no diet, supplement or exercise with mainstream evidence for speeding stem cell regeneration after a transplant. Engraftment timing depends mainly on the number and source of cells infused, the conditioning regimen, and growth factor medicines some teams give after infusion to stimulate white cell production. Good nutrition, gentle movement and sleep help the body cope with recovery, but they do not switch the marrow on faster.

What are common conditioning chemotherapy side effects?

Nausea and fatigue appear first, often within a day or two. Mucositis, inflammation of the mouth and gut lining, usually develops after conditioning ends and peaks in the week after infusion. Blood counts fall sharply, bringing infection, bleeding and anemia risks. Hair loss typically starts one to three weeks after chemotherapy begins. Some drugs affect the liver, bladder or heart, and radiation adds skin and later thyroid or eye effects, which the team monitors daily.

Does everyone lose their hair during conditioning?

Most people receiving myeloablative or reduced intensity conditioning do lose their hair, but the timing often surprises them: it usually begins one to three weeks after chemotherapy starts, so it commonly happens after the infusion rather than during the conditioning week. Nonmyeloablative regimens may cause less or partial loss. Hair generally regrows in the months after recovery, sometimes with a changed texture or color at first.

What is a rest day in a conditioning schedule?

A rest day is a planned day with no chemotherapy, usually placed right before Day 0. Its purpose is pharmacological rather than comfort: it allows drug levels in the blood to fall so that the infused stem cells are not damaged on arrival. Not every regimen includes one, and its presence or absence depends on how quickly the specific drugs clear from the body. Your calendar will show whether yours has one.

Can conditioning be stopped once it has started?

In rare situations a team may pause or modify conditioning, for example if a serious infection or unexpected organ problem appears mid-week, but this is a significant decision because the marrow is already being suppressed. In most cases the plan proceeds as scheduled with supportive care adjusted around it. The transplant physician makes any such call based on daily blood tests and examination, and will explain the reasoning if changes are needed.

References

• MedlinePlus: Bone marrow transplant
• NHS: Stem cell and bone marrow transplants
• PubMed: Defining the intensity of conditioning regimens: working definitions (Bacigalupo et al., Biol Blood Marrow Transplant, 2009)

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.