Conditioning or Preparative Regimen

Before your bone marrow or stem cell transplant, you will receive chemotherapy and/or total body irradiation to prepare your body to receive healthy blood stem cells.

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Several days prior to your transplant, you will receive high-dose chemotherapy and/or total body irradiation (TBI). This is called the preparative or conditioning regimen.

The preparative regimen is designed to:

  • kill your diseased cells and/or
  • make room in your bone marrow for healthy blood stem cells

The preparative regimen wil take place in the hospital or in an outpatient clinic over a three to seven day period.

  • If the preparative regimen is strong enough to disable your immune system, the transplant is called a myeloablative transplant.
  • If the preparative regimen is less intensive and does not completely disable your immune system, the transplant is called a reduced intensity or nonmyeloablative transplant.

High Dose Chemotherapy

Most preparative regimens include high-dose chemotherapy. Your transplant team will select the combination of chemotherapy drugs that are most effective in eliminating your disease.

The chemotherapy drugs will be given to you through a thin, flexible tube, called a central venous catheter, that is surgically inserted into a large vein in your chest near the heart. The catheter may also be called a Hickman®, Groshong® or Broviac® catheter.

The central venous catheter allows your healthcare team to give you drugs, fluids, nutrition and blood products, and to withdraw blood samples painlessly, without inserting needles into your veins. 

The catheter will remain in place until your treatment is completed. Most patients still have their catheter in place when they are discharged from the hospital.

Total Body Irradiation

Some preparative regimens include total body irradiation (TBI).

Total body irradiation is given in several sessions over a one to seven day period. You will need to sit or lie still for 10 to 45 minutes while the radiation is being delivered.

Although you will not feel the radiation, you may still find the experience unnerving. Your medical team may give you a sedative to help relieve anxiety.

See the Early Recovery page for details about possible side effects of chemotherapy and TBI.

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Next Page: Day of Transplant

Updated August, 2023