Before you have your BMT, we will give you a preparative regimen of  chemotherapy . You might also have radiation therapy . This is to help prepare your body for transplant. It is sometimes also known as conditioning therapy.

Chemotherapy
You will receive medicines called chemotherapy through your central venous catheter over several days. The type and amount of chemotherapy depend on:

• what disease we are treating
• your height and weight
• your age
• your general condition

BMT nurses and nurse coordinators will teach you about the specific chemotherapy drugs that will be included in your pre-transplant regimen. 

Doses of chemotherapy may be myeloablative or nonmyeloablative. When we give you myeloablative chemotherapy, doses are high enough to destroy the bone marrow. Non-myeloablative or reduced-intensity chemotherapy requires somewhat lower doses in select cases. While non-myeloablative chemotherapy may be referred to as a "mini-transplant," this is misleading. Recipients are still at risk for significant side effects and post-transplant complications. However, this approach may be best for older or somewhat sicker patients.

The chemotherapy will destroy diseased or cancerous cells, whether they are in the bone marrow or elsewhere.  It also suppresses, or reduces the strength of, your immune system, preventing rejection and allowing new cells to grow.

Chemotherapy will affect normal fast-growing cells, like those in your hair, mouth, stomach, and intestines. Common side effects of chemotherapy include hair loss, nausea, vomiting, diarrhea, loss of appetite, and mouth sores. These side effects are temporary, but some of them may cause moderate, or severe discomfort.

Some of the drugs we use in chemotherapy can cause bladder irritation. This may make your urine bloody or cause a burning feeling when you urinate. To prevent this, we will give you fluids through an IV. We will also ask you to urinate every one to two hours while you are receiving chemotherapy, even through the night.

Some people experience many side effects of chemotherapy, while others have very few. The BMT health care team will work with you to keep you as comfortable as possible. Medicines can help with nausea and vomiting. You can help yourself by using stress reduction techniques. This might mean:

• listening to calming music
• expressing your feelings to someone close to you
• writing in a journal
• thinking positive thoughts about how the chemotherapy is fighting your disease

It’s common to feel tired after chemotherapy. Pay attention to what your body is telling you, and make sure you get enough rest. When your immune system is suppressed, your energy level is lower and you are more susceptible to infections.

We may give you radiation along with chemotherapy. It helps destroy diseased or nonfunctioning cells and to suppress the immune system. We use three types of radiation in preparation for a BMT. What type we use depends on what disease we are treating.

Radiation therapy is not painful, but you have to hold very still while it is being given. Each session of irradiation takes five to ten minutes. No one is allowed in the room with you during the radiation treatment.

Short-term side effects of radiation treatment may include nausea and vomiting, diarrhea, hair loss, mouth sores, increased and thickened saliva, lowgrade fever, mild jaw pain, and skin rashes. Your health care team will help you manage these side effects.