Conditioning
Within 4 – 6 weeks following stem cell collection, patients are admitted to hospital to receive a high dose of melphalan (usually 200mg/m2, or 140mg/m2 for those with renal impairment) prior to SCT. This is commonly known as conditioning. The aim of high-dose melphalan is to remove any remaining myeloma cells but it also destroys all the haematopoietic cells, hence the need for a stem cell transplant. Melphalan itself only has a short half life and so the use of cryotherapy before and during HDT has been shown to reduce the incidence of oral mucositis.