After your initial consultations and research, if you decide that your child will have a bone marrow transplant at Seattle Cancer Care Alliance (SCCA), then you and your child will be scheduled to come here to finalize the treatment plan and have tests and evaluations. If a family member is donating bone marrow or stem cells for your child’s transplant, the donor may have a short evaluation at the same time.
These important steps typically take about three days, and then it takes about a week or 10 days to get final test results before we can tentatively schedule and begin the actual transplant. The exact length of time needed for evaluation, and for the wait before treatment begins, depends on your child’s condition.
Families who live in the Seattle area typically come to SCCA for appointments during the day and then go home as they wait for the treatment and transplant to start. Families who come from farther away typically use the period between evaluation and transplantation to get settled into temporary housingmand to start learning about being their child’s primary caregiver.
First Day at SCCA
During your first day at SCCA, you will meet your child’s primary provider and team nurse. If this hasn’t already been done, we will get your child’s health history and your child will have a physical exam and blood draw. You will get a tour of the SCCA Transplant Clinic on the sixth floor of the SCCA outpatient clinic on Lake Union, and you will receive a Patient & Caregiver Resource Manual. You will also be given informed-consent forms, which you sign to authorize your child’s treatment, so you have time to review them before you sit down with your child’s attending doctor for the arrival conference the next day.
During the arrival conference, on your second day at SCCA, you will meet again with your attending doctor and other members of your child’s team to discuss the treatment plan. You child’s doctor will explain the transplant process, talk with you about benefits and risks, and answer your questions. Once you feel you understand the benefits and risks and you want to continue, you will be asked to sign informed-consent forms giving us permission to treat your child.
Your child may attend this meeting or not, depending on the child’s age. You can discuss this beforehand with your child’s doctor. Older children should attend this conference so they understand what will happen to them, and our doctors will explain things in age-appropriate terms. Typically, children as young as 5 years old attend this conference, but they need not stay the entire time. If your child is too young to attend, he or she can visit with your Child Life specialist, who will use the time for medical play (to help your child understand what’s happening) and getting to know your child.
Evaluation for Transplant
After the arrival conference, your child will need several days of testing. Most tests will be done at Seattle Children’s and a few at the SCCA clinic. Tests your child will need include:
- Blood draws for tissue typing and clinical tests
- A bone marrow aspiration and possible biopsy
- Chest X-rays
- An electrocardiogram
- Pulmonary function tests, if your child is older than age 6
Your child’s doctor may order other tests as well.
You will also meet with a dietitian to discuss the special dietary needs of your child during transplant. Someone from our Oral Medicine Department will check your child’s teeth. Ideally, you should take your child to see a dentist for a checkup and any necessary dental work before arriving in Seattle.
When results of the tests are available, typically in seven to 10 working days, then you will sit down with your child’s doctor and medical team to discuss the results, finalize the treatment plan, set a tentative transplant date, get any additional questions answered, and provide your consent, if you haven’t already, if you choose to proceed with the treatment. This is sometimes called a data-review conference or a pre-transplant conference.
Now the transplant can be scheduled and treatment can begin.