Side effects of a stem cell or bone marrow transplant …

The side effects of astem cell or bone marrow transplant are caused by:

You might have extra side effects if you also have whole body radiotherapyas part of the treatment. Whole body radiotherapy is also called total body irradiation or TBI.

All the side effects are at their worst when you have just had your high dose chemotherapyand for a few weeks afterwards. When your blood counts start to rise (engraftment) you will start to feel better. Let your team know if you have any side effects. They can do a lot to help you.

In the longer term, these treatments often cause infertility. Some people who have had a transplant do go on to have children, but this is still quite unusual.

You have a low white blood cell count after your intensive treatment. So you are at more risk of getting an infection. This can be from normally harmless bacteria that we have in our digestive system and on our skin.

To try and stop this from happening youmight have:

You need to have a shower every day to reduce the risk of infection. If you are finding it hard to shower, let your nurse know and they can help.Your room is cleaned and your bedsheets are changed every day.

Your visitors should wash their hands before they come into your room. They might need to weargloves and aprons like the nurses and doctors. They shouldn'tvisit if they have coughs or colds.

You are also at risk of infection from some foods. The rules about what you can eat are different in different hospitals. While you are an inpatient and if you need it, youhave meals that are less likely to cause an infection. Talk to your nurse and dietitian about getting a good balance between what you fancy eating and what might cause an infection.

When first back at home you might need to take some precautions. For example:

Ask your medical teamif you need to follow a special diet at home and how long this should be for.

Even with these precautions you are very likely to get an infection at some point. You willneed antibiotics to treat the infection.

After a transplant you lose immunity to diseases you were vaccinated against as a child. Your transplant team will let you know which vaccinations you need to have again after your treatment. It's important that all your family have the flu vaccine and any children in your close family have their childhood immunisations.

Some pre school and primary school childrenhave the flu vaccine as a nasal spray. If your immune system is severely weakened, you should avoid close contact with children who have had the nasal spray for 2 weeks following their vaccination. Speak to your doctor if you are not sure whether this applies to you.

Your red blood cell count will fall after treatment. Your transplant team will check your red blood cell count every day. If it gets too low you might feel:

You mightneed a blood transfusion to top up your red blood cells. This will make you feel better almost straight away.

Sometimes people have an allergic reaction to a blood transfusion. Let your nurse or doctor know as soon as possible if you feel hot and shivery, or itchy. You will havemedicines to stop the reaction. Your nursemay also slow down the transfusion rate.

More rarely, some people have:

Tell your doctor or nurse straight away if you haveany of the above. Your nurse will need to treat your reaction and mightstop the infusion.

Your platelet level will fall after your treatment. Platelets help the blood to clot. A low platelet level means you are at risk of bleeding. You might find you are bruising more easily than normal.

Tell your nurse or doctor straight away if you notice:

Your treatment team will arrange for you to have a platelet transfusion. You have the platelets as a drip into your vein. It takes about half an hour.

Sometimes people have a reaction to platelets. This is uncomfortable at the time but soon passes. Let your nurse or doctor know as soon as possible if you feel:

Your platelet count can take a while to get back to normal after a stem cell or bone marrowtransplant. It might take longer to recover ifyou have had your own stem cells (rather than a donor's stem cells).

You might feel sick after your chemotherapy and radiotherapy. But youshould start to feel better after a couple weeks. Unfortunately other treatments you have can make you feel sick, such as antibiotics. You can have anti sickness medicines for as long as you need them.

You might have diarrhoea as a reaction to the radiotherapy or chemotherapy. You might also have it due to an infection or because you have developed another side effects called graft versus host disease. Tell your nurse or doctor if the diarrhoea is severe. They will give you medicine that will help. You will also need treatment for the underlying cause of the diarrhoea.

A sore mouth and mouth ulcers are very common after a transplant.They can develop as a reaction to chemotherapy or radiotherapy or from a mouth infection.

Your can have mouthwashes andlozenges to suck to try to prevent infection. Ask for painkillers if you need them. Sucking on ice cubes can sometimes help to reduce the pain.

You won't have much appetite just after your transplant. Try small meals throughout the day andeat whenever you feel like it. Your dietitian will give you high calorie drinks if you can't eat much.Or you might have liquid nutrition through a tube into your tummy or through your central line.

You will feel very tired and run down after your transplant. This will be at its worst during the second and third weeks when your blood cell counts are at their lowest.

Slowly you will feel that you have more energy. But you will feel more tired than usual for quite a long time after your transplant. This could last forup to a couple of years.

A longer term side effect of a transplant is infertility. This means you will no longer be able tobecome pregnantor father a child naturally. This iscaused by total body irradiation andthe high doses of chemotherapy.

Some people who havehad a transplant do go on to have children naturally, but this isunusual.Sometimes it is possible for men and teenage boys to store sperm before they start their chemotherapy. This is calledsperm banking.

Treatment can cause anearly menopause for women. You might have hormone replacement therapy (HRT) to help with the symptoms. Some women are able to store embryosor eggs before starting cancer treatment, but this is not always possible. Research is going on all the time to try to help women have children after cancer treatment.

If you have had a transplant from a relative or a matched unrelated donor, you are at risk of GvHD.This is because the donor stem cellscontainimmune cells from the donor.These cells can sometimes attack some of your own body cells.

GvHD can cause:

GvHD can be severe and even life threatening for some people. But mild GvHD can also be helpful for some. It is an immune system reaction and can help to kill off any cancercells left after your treatment.

Let your treatment team know if you have any signs of GvHD. You can have treatments withimmunosuppressives to help reduce the reaction.

This page is due for review. We will update this as soon as possible.

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Side effects of a stem cell or bone marrow transplant ...