Internal Medicine Department
Hematology Division

Initial Evaluation

Deciding to have a bone marrow transplant is a significant event.  It is like embarking on a long, challenging journey.  Throughout the journey, patients will encounter a number of challenges and obstacles that can be overcome.  This is a guide to help understand the steps to take and how to prepare for this journey.  The planning process begins when the patient first considers transplant as a treatment option that has been recommended by a physician due to the state or diagnosis of their disease.

Choosing a Transplant Center

Generally four factors affect a patient’s decision to select a given center for transplant:

  1. Opinion of the referring physician
  2. Geographic location of the center
  3. Insurance reimbursement issues
  4. Personal preferences

Appointments and Referrals

To make an appointment for yourself, a family or friend, it is best to have your physician contact a Bone Marrow Transplant physician to assure the appropriateness for a transplant.

The bone marrow transplant physician will then contact a bone marrow transplant coordinator who will in turn contact the patient to collect preliminary information such as: name, age, date of birth, address, insurance and current status.  The clinical coordinator will review the information and determine eligibility for therapies offered by the Utah Blood and Marrow Transplant Program.  The Coordinator will also set up an initial consultation for the patient to meet with the transplant physician.

In some cases, the Coordinator may recommend that a patient be seen at another institution due to insurance coverage.  Prior to the appointment, the patient’s relevant medical records will be requested and reviewed by the consulting physician.  Appointments are usually scheduled two to three weeks in advance to allow time for medical records to be obtained and reviewed prior to the consultation.  If appropriate, tissue typing studies may be initiated so that results are available at the time of the appointment.

A packet of information will be sent to help the patient prepare for their visit to Salt Lake.  It includes transportation information, short-term housing options, personal history form, physician correspondence list and A Medical and Educational Handbook.  The patient is encouraged to read the handbook and prepare a list of questions to be addressed by the consulting physician.

The Consultation Appointment

The medical consultation takes place at the University of Utah Hospital and generally lasts 1½–3 hours.  A physician assistant or nurse practitioner will meet with the patient first to review past medical history, family history and do a physical exam.  The consulting physician will then meet with the patient to discuss a variety of different topics.  Topics discussed may include treatment options, success rates for specific procedures and management of complications.  If further clinical information is needed, the consultant my order laboratory work and/or diagnostic procedures.  They may also recommend that the referring physician follow up on some procedures as well. The consulting physician will then dictate a comprehensive letter to the referring physician summarizing the patient’s case and proposed treatment plan.  A copy of this letter will be mailed to the patient.  The insurance company will also receive a copy with the request prior authorization for the recommended treatment plan.