After your transplant, the new stem cells establish themselves in your bone marrow. Then they begin to make new blood cells. This process is called engraftment. It usually happens during the first two to four weeks after transplant.

We will check your white blood cell counts regularly for early signs of engraftment. The recovery of white blood cells is one of the earliest signs of stem cell growth. We will also pay particular attention to your neutrophil count. We often call this the absolute neutrophil count or ANC. Neutrophils fight infection from bacteria, yeasts or fungi.

We may need to do a bone marrow biopsy to check for engraftment three to four weeks after your transplant. Your white blood cell counts will vary a great deal as the new graft of stem cells establishes itself. Getting back to normal levels of platelets and red cells is often a bit slower. So you will continue to receive blood transfusions until you can make enough red blood cells and platelets on your own.