Transplant Decision

After receiving medical recommendations, each family must make a decision about whether or not their child will undergo a BMT. Parents need thorough information on this treatment option, as well as an understanding when a BMT should be done. A face-to-face conference will be set up for the parents (and the child also, if age appropriate) with the attending physician and other BMT team members to discuss the pro’s and con’s, and to go over details of the planned BMT protocol, its risks.  Parents will be given a protocol document to take with them to read over (with a chance to discuss further or use to seek other medical opinions), which they will asked to sign to agree for the BMT to take place. This is called the informed consent process.  The signed legal document is sometimes informally also referred to as the” informed consent” as well.

Timing of Transplant

Increasingly, medical recommendations are being made for a BMT to be considered as part of treatment soon after a patient’s diagnosis. In the early days of BMT, it was considered to be a drastic last step only to be undertaken after other treatments had failed.  The experience of the past 2 decades has shown that, at least in some cases, earlier transplants may offer a better chance of a cure and/or that patient can better withstand BMTs if they have not been subjected to many other toxic treatments beforehand. While much progress has been made in controlling or eradicating certain cancers with new medications, many diseases are presently cured only with transplant. Better methods have also been developed to prevent or better control many of the devastating side effects of BMT that also affect survival Therefore patient families may want to find out early on if a BMT might be indicated for their child. Some experts feel that if patients from demographic groups under-represented in the registries do not have a sibling donor, then this factor may indicate the need for an earlier referral, as more time will likely be necessary for searching for an unrelated donor.

Some experts feel that if patients from demographic groups under-represented in the registries do not have a sibling donor, then this factor may indicate the need for an earlier referral, as more time will likely be necessary for searching for an unrelated donor.

The American Society for Blood & Marrow Transplantation and the NMDP have created a BMT referral timing tool, which patients and physicians can discuss together.