Also, you should not clean pet cages or litter boxes during this time. Instead, give this task to a family member or friend. Your transplant team will tell you and your family in detail about the precautions you need to follow. There are many viruses, bacteria, and fungi that can cause infection after your transplant. You may be at risk for some more than others. Despite all these precautions, patients often develop fevers, one of the first signs of infection. In fact, sometimes fever is the only sign of infection, so it's very important to contact your cancer care team if you have one or if you have any other signs of infection.
You'll probably be asked to take your temperature by mouth every day or twice a day for a while. And your cancer care team will let you know when you should call in your temperature to them. If you get a fever, tests will be done to look for possible causes of the infection chest x-rays, urine tests, and blood cultures and antibiotics will be started.
Platelets are the blood cells that help blood to clot. While you wait for your transplanted stem cells to start working, your transplant team may have you follow special precautions to avoid injury and bleeding.
Platelet counts are low for at least several weeks after transplant. In the meantime, you might notice easy bruising and bleeding, such as nosebleeds and bleeding gums. If your platelet count drops below a certain level, a platelet transfusion may be needed. It also takes time for your bone marrow to start making red blood cells, and you might need red blood cell transfusions from time to time as you recover.
For more information on the transfusion process, see Blood Transfusion and Donation. But some lung problems can happen much later — even 2 or more years after transplant. Pneumonia caused by infection happens more often, but pneumonitis may be caused by radiation, graft-versus-host disease, or chemo rather than germs. Pneumonitis can be severe, especially if total body irradiation was given with chemo as part of the pre-transplant conditioning treatment.
Chest x-rays will be taken in the hospital to watch for pneumonitis as well as pneumonia. Some doctors will do breathing tests every few months if you have graft-versus-host disease see next section.
You should report any shortness of breath or changes in your breathing to your doctor or transplant team right away. There are many other types of lung and breathing problems that also need to be handled quickly. Graft-versus-host disease GVHD can happen in allogeneic transplants when the immune cells from the donor see your body as foreign. The donor immune cells may attack certain organs, most often the skin, gastrointestinal GI tract, and liver.
This can change the way the organs work and increase the chances of infection. GVHD reactions are very common and can range from barely noticeable to life-threatening. Doctors think of GVHD as acute or chronic. Acute GVHD starts soon after transplant and lasts a short time.
Chronic GVHD starts later and lasts a long time. A person could have one, both, or neither type of GVHD. Acute GVHD can happen 10 to 90 days after a transplant, though the average time is around 25 days. About one-third to one-half of allogeneic transplant recipients will develop acute GVHD. The first signs are usually a rash, burning, and redness of the skin on the palms and soles. This can spread over the entire body. Other symptoms can include:.
Doctors try to prevent acute GVHD by giving drugs that suppress the immune system, such as steroids glucocorticoids , methotrexate, cyclosporine, tacrolimus, or certain monoclonal antibodies.
Login Register. We want you to take advantage of everything Cancer Therapy Advisor has to offer. To view unlimited content, log in or register for free. Register now at no charge to access unlimited clinical news, full-length features, case studies, conference coverage, and more. Non-infectious complications after bone marrow transplant: graft failure What every physician needs to know about non-infectious complications after bone marrow transplant: graft failure: Graft failure Graft failure GF is a life threatening complication of hematopoietic stem cell transplantation HCT.
Jump to Section Non-infectious complications after bone marrow transplant: graft failure What every physician needs to know about non-infectious complications after bone marrow transplant: graft failure: Graft failure What features of the presentation will guide me toward possible causes and next treatment steps: Symptoms Physical examination findings What laboratory studies should you order to help make the diagnosis and how should you interpret the results?
Initial tests What conditions can underlie non-infectious complications after bone marrow transplant: graft failure: Differential diagnosis When do you need to get more aggressive tests: Bone marrow aspirate and biopsy What imaging studies if any will be helpful? What therapies should you initiate immediately and under what circumstances — even if root cause is unidentified? Urgent treatment What other therapies are helpful for reducing complications?
Graft source Conditioning regimen Dose of stem cells Immunosuppressive drugs What should you tell the patient and the family about prognosis?
In refractory cases Pathophysiology Risk factors Insufficient number of stem cells Transplantation Post-transplantation Complications of transplantation augmenting GF risks What other clinical manifestations may help me to diagnose non-infectious complications after bone marrow transplant: graft failure? What other additional laboratory studies may be ordered?
Please login or register first to view this content. Open Next post in Hematology Close. Coagulopathy in liver disease. You may need medicine to manage complications, such as nausea and diarrhea. After your bone marrow transplant, you'll remain under close medical care. If you're experiencing infections or other complications, you may need to stay in the hospital for several days or sometimes longer. Depending on the type of transplant and the risk of complications, you'll need to remain near the hospital for several weeks to months to allow close monitoring.
You may also need periodic transfusions of red blood cells and platelets until your bone marrow begins producing enough of those cells on its own. You may be at greater risk of infections or other complications for months to years after your transplant. You'll have periodic lifelong follow-up appointments with your doctor to monitor for late complications. If your bone marrow transplant is using stem cells from a donor allogeneic transplant , your doctors may prescribe medications to help prevent graft-versus-host disease and reduce your immune system's reaction immunosuppressive medications.
After your transplant, it takes time for your immune system to recover. During this time, you may be given medications to prevent infections. After your bone marrow transplant, you may need to adjust your diet to stay healthy and to prevent excessive weight gain.
Your nutrition specialist dietitian and other members of your transplant team will work with you to create a healthy-eating plan that meets your needs and complements your lifestyle. Your dietitian can also give you food suggestions to control side effects of chemotherapy and radiation, such as nausea. After your bone marrow transplant, regular physical activity helps you control your weight, strengthen your bones, increase your endurance, strengthen your muscles and keep your heart healthy.
As you recover, you can slowly increase your physical activity. Taking steps to prevent cancer is even more important after your transplant. Don't smoke. Wear sunscreen when you're outside, and be sure to get the cancer screenings your doctor recommends.
A bone marrow transplant can cure some diseases and put others into remission. Goals of a bone marrow transplant depend on your individual situation, but usually include controlling or curing your disease, extending your life, and improving your quality of life. Some people complete bone marrow transplantation with few side effects and complications. Others experience numerous challenging problems, both short and long term.
The severity of side effects and the success of the transplant vary from person to person and sometimes can be difficult to predict before the transplant.
It can be discouraging if significant challenges arise during the transplant process. However, it is sometimes helpful to remember that there are many survivors who also experienced some very difficult days during the transplant process but ultimately had successful transplants and have returned to normal activities with a good quality of life.
Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. Living with a bone marrow transplant or waiting for a bone marrow transplant can be difficult, and it's normal to have fears and concerns.
Having support from your friends and family can be helpful. Also, you and your family may benefit from joining a support group of people who understand what you're going through and who can provide support.
Support groups offer a place for you and your family to share fears, concerns, difficulties and successes with people who have had similar experiences. You may meet people who have already had a transplant or who are waiting for a transplant. Bone marrow transplant care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version.
Overview A bone marrow transplant is a procedure that infuses healthy blood-forming stem cells into your body to replace your damaged or diseased bone marrow. Allogeneic stem cell transplant Autologous stem cell transplant.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references AskMayoExpert. Hematopoietic stem cell transplant. Patients typically experience symptoms of abdominal fullness or swelling, liver tenderness and weight gain from fluid retention. Development of strategies to prevent or treat VOD is an active area of clinical investigation.
High-dose chemotherapy can directly damage the cells of the lungs. This complication of transplant may occur anytime, from a few days after high-dose chemotherapy to several months after treatment. This often occurs after a patient has returned home from a transplant center and is being seen by a local oncologist. Patients typically experience a dry non-productive cough or shortness of breath. Both patients and their doctors often misinterpret these early symptoms.
Patients experiencing shortness of breath or a new cough after autologous transplant should bring this to the immediate attention of their doctor since this can be a serious and even fatal complication. Graft failure is extremely unusual in autologous stem cell transplantation. Graft failure occurs when bone marrow function does not return. The graft may fail to grow in the patient—resulting in bone marrow failure—with the absence of red blood cells, white blood cells and platelet production.
This results in infection, anemia and bleeding. Graft failure may also occur in patients with extensive marrow fibrosis before transplantation, a viral illness or from the use of some drugs such as methotrexate. In leukemia patients, graft failure often is associated with a recurrence of cancer; the leukemic cells may inhibit the growth of the transplanted cells. In some cases, the reasons for graft failure are unknown.
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