Road to Recovery

Here are the steps in getting a bone marrow transplant that face leukemia patients such as Mighty Duck defenseman Milos Holan.

DONATION

* After a match is located, the prospective donor undergoes a thorough physical to determine if donating would be harmful to the donor or recipient. After counseling, the anonymous donor signs an “intent to donate” form.

* Doctors extract 2%-5% of the donor’s liquid marrow from the back of the pelvis with a special needle and syringe during an hourlong procedure. Though anesthesia makes the procedure painless, the donor’s lower back area is usually sore for about a week.

TRANSPLANT

* Before the transplant, the patient undergoes about eight days of intensive chemotherapy or radiation to wipe out all disease. Because the treatment destroys the immune system, the patient probably will die unless he receives a marrow transplant.

* The donated marrow is transfused directly into the patient’s bloodstream, much like a blood transfusion. Healthy marrow cells travel to bone cavities, where they begin to grow and replace the old marrow.

RECOVERY

* The patient must be isolated in a protected hospital environment for three to six weeks as the new marrow produces enough white blood cells to fight off disease. Possible complications include non-engraftment, rejection, graft-versus-host disease, infection and relapse.

* Many patients leave the hospital after six weeks, but must remain under a recovery watch for three to four months and take extreme precautions against infection. Recovery takes a year.

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Sources: National Marrow Donor Program, Bone Marrow Transplants: A Guide for Cancer Patients and Their Families, Dr. Stephen Forman.