Physical Challenges
A transplant is not a walk in the park. It is a physically taxing process and you will feel sick, tired and weak at different times along the way.
Normal activities like walking, sitting up in bed, reading, talking on the phone, visiting friends or even watching TV may be exhausting.
Complications can develop. Most are temporary and reversible but some can be serious.
Most patients are hospitalized for a time after the transplant. When you are released, or if you were treated as an outpatient, there will be daily trips to the outpatient clinic. Over time, these will become weekly, then monthly visits.
Eating Difficulties
A common side effect of the radiation or high dose chemotherapyDrug or combination of drugs designed to kill cancerous cells. received during the preparative regimenThe treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A preparative regimen may include chemotherapy, monoclonal antibody therapy, and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow, helps prevent the patient's body from rejecting the transplanted cells, and helps kill any cancer cells that are in the body. Also called conditioning regimen. is mucositisA complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth.. Mucositis is irritation of the lining of the mouth, throat and gastrointestinalRefers to the stomach and intestines. track which can be painful. Patients may also experience nausea, vomiting, dry mouth or diarrhea due to the medications they have been given.
These side effects are common and temporary. You will be given medications to help control them and make you more comfortable.
These side effects can affect your appetite and make it difficult to get enough calories, proteinOne of the three nutrients that supply calories to the body. Protein helps build muscle, bone, skin, and blood. and fluids in the early weeks after transplant. Certain medications also cause a lack of appetite. Our brochure Eating Well, Living Well After Transplant provides tips on how to overcome these problems.
Temporary Hair Loss
Hair loss is also a common side effect of the preparative regimen. In most cases, hair begins growing back in six months. However, it may be a different thickness, curliness or texture.
GraftHealthy blood forming stem cells used to replace a patient's diseased blood forming stem cells-versus-Host Disease
If you were transplanted with cells from a donor, your medical team will closely monitor you for signs of graft-versus-host disease (GVHDGraft-versus-Host-Disease. A disease caused when the donor's stem cells (the graft) attack the normal tissue of the transplant patient. Also called GVHD.). You will receive medications to reduce the risk of severe GVHD. Medications commonly used for this purpose are a combination of:
- cyclosporine and methotrexate or
- tacrolimus and methotrexate or
- cyclosporine and mycophenolate mofetil
You can learn about common side effects associated with these drugs by consulting our drug database.
These medications will weaken your immune system, so great care will be taken to protect against infections while you are on them. Read the acute graft versus host disease section to learn more about this complication
Effect on Your Organs
High dose chemotherapy and/or radiation can also cause temporary damage to your organs. This is usually reversible. Your medical staff will monitor you daily so that they can detect and treat any problem quickly if it arises.
Veno-occlusive disease (VOD) is a complication that occasionally occurs after transplant and interferes with your liver's ability to get rid of waste products in the bloodstream. Symptoms include pain in the upper right section of your abdomen, weight gain and jaundiceA condition in which the skin and the whites of the eyes become yellow, urine darkens, and the color of stool becomes lighter than normal. Jaundice occurs when the liver is not working properly or when a bile duct is blocked. (yellowing of the skin and eyes). If VOD occurs, your medical team may change your medications, reduce the amount of salt in your diet and give you a drug to prevent blood clots. A new drug being investigated called defibrotide has shown some promise in treating patients with VOD.
Sometimes the chemotherapy and/or radiation damages the lungs. If this occurs, steroids may be effective in resolving the problem. In some cases, a patient may require oxygen or the use of a ventilator.
Consult our patient handbooks on transplantation for additonal details about these and other less common side effects of transplant.
Reduced Intensity TransplantTransplant using lower dosages of chemotherapy and/or radiation than standard transplants.
If you have a reduced intensityLower than standard dosage. transplant the difficulties you encounter after transplant may be less severe. Please consult our book Bone Marrow & Blood Stem Cell Transplants: A Handbook for Patients for more information about reduced intensity transplants. You can also review the National Marrow Donor Program's web page on reduced intensity transplants for more details.
Putting Things Into Perspective
Although the list of complications may seem overwhelming, it helps to remember that blood stem cell transplants have been performed for more than four decades and transplant centers are experienced in treating complications. Most complications are temporary and reversible. Everyone recovers at their own pace and set backs along the way are common. Taking one day at a time, is the best way to manage the recovery period.
