TCTCN Study Plan: 8-Week Schedule
Week-by-Week Preparation Guide for the ONCC TCTCN Exam
8-Week Preparation Guide
Certifying Body: Oncology Nursing Certification Corporation (ONCC)
Exam: Transplantation and Cellular Therapy Certified Nurse (TCTCN)
Format: 165 multiple-choice questions (125 scored, 40 unscored pretest)
Time: 3 hours
Cost: $300 (ONS/APHON member) or $420 (non-member)
Passing Score: Scaled score of 55 (25–75 scale)
Eligibility: Active RN license + 2,000 hours HSCT/cellular therapy practice in past 4 years + 10 CE hours in HSCT/cellular therapy (past 3 years)
About the Exam
The TCTCN (formerly BMTCN) validates specialized knowledge in hematopoietic stem cell transplantation and cellular therapy. The 2024 role delineation study defines six content domains with equal weighting for the four clinical domains.
Exam Content Domains (Effective 2026)
Week-by-Week Study Plan
Weeks 1–2: Foundations of HSCT and Cellular Therapy (22%)
Goal: Build core transplant and cellular therapy knowledge
Key Topics:
- •Hematopoietic cell lineage and immune system basics
- •HLA typing and its role in donor selection
- •Types of transplant: autologous vs. allogeneic (MRD, MUD, mismatched, cord, haploidentical)
- •Cellular therapies: CAR-T, TIL, NK cells, bispecific antibodies, gene therapy, DLI
- •Cell sources: peripheral blood, bone marrow, umbilical cord, tumor
- •Indications: malignant (leukemia, lymphoma, myeloma), non-malignant (aplastic anemia, sickle cell), immune disorders
- •Recipient evaluation and suitability assessment
- •Donor selection, care, and education
- •Caregiver education requirements
Study Activities:
- •Create comparison charts for transplant types (autologous vs. allogeneic, sources, advantages/disadvantages)
- •Study HLA matching principles and donor selection algorithms
- •Review the cellular therapy pipeline: CAR-T, TIL, gene therapy — mechanisms and indications
Weeks 3–4: HSCT and Cellular Therapy Process (22%)
Goal: Master conditioning, product administration, and acute complications
Key Topics:
- •Product collection: mobilization (G-CSF, plerixafor), apheresis, bone marrow harvest, cord blood collection
- •Conditioning regimens: intensity levels (myeloablative, reduced-intensity, non-myeloablative)
- •Conditioning agents: chemotherapy (busulfan, cyclophosphamide, fludarabine), TBI, targeted therapies
- •Acute conditioning complications: mucositis, nausea/vomiting, hepatic toxicity, hemorrhagic cystitis
- •Product administration: fresh vs. cryopreserved, DMSO toxicity, infusion reactions
- •Hematologic compatibilities: ABO incompatibility (major vs. minor), Rh incompatibility
Study Activities:
- •Create a conditioning regimen table: agents, intensity, indications, key side effects
- •Study ABO incompatibility management: major (plasma depletion) vs. minor (RBC depletion)
- •Review product handling: storage, thawing, infusion rate, DMSO side effects
Weeks 5–6: Post-HSCT Management (22%) + Post-Cellular Therapy (22%)
Goal: Master the two largest clinical domains (combined 44%)
Post-HSCT — Early Complications:
- •Engraftment: neutrophil and platelet recovery timelines, engraftment syndrome
- •Acute GVHD: grading (I–IV), skin/liver/GI manifestations, treatment (steroids, ruxolitinib)
- •Infection prevention: neutropenic precautions, prophylaxis (antibacterial, antifungal, antiviral), CMV monitoring
- •SOS/VOD: risk factors, diagnosis (modified Seattle/Baltimore criteria), treatment (defibrotide)
- •Graft rejection/failure: primary vs. secondary, chimerism monitoring
Post-HSCT — Late Complications:
- •Chronic GVHD: classification (limited/extensive or NIH scoring), organ involvement, treatment
- •Late effects: cataracts, infertility, endocrine dysfunction, secondary malignancies, BOS
- •Immune reconstitution timeline and vaccination schedules
- •Disease relapse monitoring and management
Post-Cellular Therapy:
- •CAR-T complications: cytokine release syndrome (CRS) grading and management (tocilizumab), neurotoxicity (ICANS) grading and management
- •HLH/MAS: recognition, treatment (etoposide, dexamethasone)
- •B-cell aplasia and hypogammaglobulinemia management
- •Treatment failure and bridging strategies
Week 7: Quality of Life & Professional Performance (12%)
Goal: Master the non-clinical domains
Key Topics:
- •Psychosocial support: body image, sexuality, return to work, financial toxicity
- •Survivorship care: long-term follow-up, screening for late effects
- •Palliative care and end-of-life considerations
- •Cultural and spiritual competence
- •FACT accreditation standards
- •REMS (Risk Evaluation and Mitigation Strategies) programs for cellular therapies
- •Evidence-based practice and professional development
- •Self-care for transplant nurses
Week 8: Practice Exams & Final Review
- •Review ONCC TCTCN Test Content Outline and reference list
- •Focus on weak areas from each domain
- •Create algorithm flowcharts: GVHD grading, CRS management, SOS management, infection workup
- •Study CAR-T products: tisagenlecleucel, axicabtagene ciloleucel, lisocabtagene maraleucel — indications and key differences
- •Night before: light review only. Get rest.
Recommended Study Resources
- •ONCC TCTCN Test Content Outline (2026) — official blueprint
- •ONCC Test Reference List — updated annually
- •Capra Academy TCTCN Study Guide — comprehensive review with practice questions
- •FACT-JACIE Standards — accreditation standards for transplant programs
- •ASBMT (American Society for Blood and Marrow Transplantation) — clinical guidelines
Frequently Asked Questions
How many hours should I study for the TCTCN exam?
Most successful candidates study 100–150 hours over 8–10 weeks (2–3 hours daily). Focus extra time on the four clinical domains (combined 88% of exam).
Is the TCTCN exam hard?
ONCC does not publish TCTCN-specific pass rates. Based on comparable ONCC certifications (CPHON: ~74%), the TCTCN is expected to have a similar difficulty level. The breadth of transplant and cellular therapy content makes it moderately challenging.
What is the difference between TCTCN and BMTCN?
TCTCN is the renamed version of BMTCN, effective January 2026. The name change reflects the broader scope of cellular therapy beyond traditional bone marrow transplant. The exam content and eligibility remain the same.
Should I take the DoubleTake option?
Yes — the $100 DoubleTake option is worthwhile insurance. If you fail on your first attempt, you get one retake without paying the full $300–$420 fee again.
What CAR-T products should I know for the TCTCN exam?
Know the FDA-approved CAR-T products: tisagenlecleucel (Kymriah), axicabtagene ciloleucel (Yescarta), lisocabtagene maraleucel (Breyanzi), idecabtagene vicleucel (Abecma), and ciltacabtagene autoleucel (Carvykti). Understand their indications, CRS risk profiles, and monitoring requirements.
Ready to Start Studying?
Our TCTCN Study Guide covers every content area on the exam with practice questions and detailed answer rationales.