For a successful bone marrow transplant to be performed, your medical team will have to complete a number of steps in sequence. Each step involves critical decisions and potential risks.
1. Determine that the cancer is sensitive to high-dose therapy and cannot
be cured with simpler treatment.
For both doctor and patient this is the hardest part of the procedure. The candidate for a transplant has to
have a disease serious enough that a treatment as risky as bone marrow transplantation is a reasonable
option.
What makes the decision particularly difficult is that transplants are much more useful when patients are
referred for treatment early in the course of their disease. Then they are more likely to be healthy. There is
less cancer and it hasn't become highly resistant to therapy after repeated treatments. But transplant-related
deaths are least acceptable in these early stages. The easiest course would be to refer a patient for
transplantation when he or she is almost dead from cancer and all other therapies have failed. Unfortunately,
at that point we know bone marrow transplantation is not likely to be beneficial.
The best approach, then, is to identify those who might benefit from the procedure and refer them for the
treatment as soon as it seems clear that they cannot be cured with a simpler therapy.
