A bone marrow transplant is a very involved and complex procedure. They can be an excellent option for patients with certain kinds of diseases, but in order to make sure that they have the greatest chance of success, there are many steps that have to be followed before the actual procedure would take place.
At the first consultation appointment, the hematologist-oncologist you are seeing will likely spend most of the time going over your health history, explaining the transplant process, and answering your questions. Depending on the transplant center, you may or may not start the pre-transplant testing process at that appointment.
Overall, before undergoing a transplant the medical team has to be sure that you are physically and psychologically healthy enough for the procedure. It is important that you understand all of the risks and benefits for the procedure, and most centers will have patients talk with a social worker (or someone not the transplant physician) to make sure that you understand the procedure and have the support systems in place to go through what can be a very long process. Then, you will need to have a series of laboratory blood tests done to make sure that your heart, kidneys, and liver are in good health. Undergoing a transplant places stress on all of these organs, and some of the drugs used to get rid of your bone marrow before giving you new bone marrow can have toxic side effects on organs like the heart and lungs. It is important to make sure that all of these organs are healthy *before* starting the transplant process so that you can be monitored appropriately once the transplant starts. For this reason you will probably also need to undergo an echocardiogram (ultrasound
exam of your heart) and likely pulmonary function testing
(where you breath into a machine that measures how well your lungs are working) in addition to the blood work. All of this testing is usually set up after the initial consultation appointment.
So, for the first appointment you should be prepared to ask a lot of questions and then, depending on what you and your doctor
decide, plan to start scheduling outpatient appointments for pre-transplant testing.