Bone marrow transplant - discharge
Transplant - bone marrow - discharge; Stem cell transplant - discharge; Hematopoietic stem cell transplant - discharge; Reduced intensity, non-myeloablative transplant - discharge; Mini transplant - discharge; Allogenic bone marrow transplant - discharge; Autologous bone marrow transplant - discharge; Umbilical cord blood transplant - discharge
What to Expect at Home
You have had a bone marrow transplant. It will take 6 months or more for your blood counts and immune system to recover fully. During this time, your risk for infections, bleeding, and skin problems is higher.
Your body is still weak. It may take up to a year to feel like you did before your bone marrow transplant. It is likely that you will get tired very easily. You will also likely have a poor appetite.
If you received bone marrow from someone else, you may develop signs of graft-versus-host disease (GVHD). Ask your doctor or nurse to tell you what signs of GVHD you should watch for.
Brush your teeth and gums 2 to 3 times a day for 2 to 3 minutes each time. Use a toothbrush with soft bristles.
- Let your toothbrush air dry between brushings.
- Use a toothpaste with fluoride.
Floss gently one time a day.
Rinse your mouth 4 times a day with a salt-and-baking-soda solution (mix one half teaspoon of salt and one half teaspoon of baking soda in 8 ounces or 1 cup of water). Your doctor may prescribe a mouth rinse.
Do not use mouth rinses with alcohol in them.
Use your regular lip care products to keep your lips from drying and cracking. Tell your doctor if you develop new mouth sores or pain.
Chew sugarless gums or suck on sugar-free popsicles or sugar-free hard candies. Avoid mouth rinses that have alcohol in them. Do not eat foods and drinks that have a lot of sugar in them.
Take care of your dentures, braces, or other dental products.
- If you wear dentures, put them in only when you are eating. Do this for the first 3 to 4 weeks after your transplant. Do not wear them at other times during the first 3 to 4 weeks.
- Brush your dentures 2 times a day. Rinse them well.
- Soak your dentures in an antibacterial solution (a solution to kill germs) when you are not wearing them.
You need to take care not to get infections for up to 1 year or more after your transplant.
Practice safe eating and drinking during cancer treatment.
- Be careful what you eat. Do not eat or drink anything that may be undercooked or spoiled.
- Make sure your water is safe.
- Know how to cook and store foods safely.
- Be careful when you eat out. Do not eat raw vegetables, meat, or fish, or anything else you are not sure is safe.
Wash your hands with soap and water often:
- After being outdoors
- After touching body fluids, such as mucus or blood
- After changing a diaper
- Before handling food
- After using the telephone
- After doing housework
- After going to the bathroom
Keep your house clean. Stay away from crowds. Ask visitors who have a cold to wear a mask, or to not visit. Do not do yard work or handle flowers and plants.
Be careful with pets and animals.
- If you have a cat, keep it inside.
- Have someone else change the litter box every day.
- Do not play rough with cats. Scratches and bites can get infected.
- Stay away from puppies, kittens, and other very young animals.
Ask your doctor what vaccines you may need and when to get them.
Know how to care for your central venous line or PICC line.
If your doctor or nurse tells you your platelet count is low, learn how to prevent bleeding during cancer treatment.
Start to walk. Slowly increase how far you go based on how much energy you have.
You need to eat enough protein and calories to keep your weight up.
Ask your doctor about liquid food supplements. These can help you get enough calories and nutrition.
Be very careful about being in the sun. Wear a hat with a wide brim. Use sunscreen with SPF 30 or higher on any exposed skin. Do not smoke.
You will need close follow-up care from your transplant doctor and nurse for at least 3 months.
When to Call the Doctor
If you have any of these symptoms, call your doctor:
- Diarrhea that does not go away or is bloody
- Severe nausea, vomiting, or loss of appetite
- Inability to eat or drink
- Extreme weakness
- Redness, swelling, or draining from any place where you have an IV line inserted into your body
- Pain in your stomach area
- Fever, chills, or sweats. These may be signs of infection.
- A new skin rash or blisters
- Jaundice (the white part of eyes or skin looks yellow)
- A very bad headache or a headache that does not go away
- A cough that is getting worse
- Trouble breathing when you are at rest or when you are doing simple tasks
- Burning when you urinate
National Cancer Institute. Chemotherapy and you: support for people who have cancer (PDQ). June Accessed May 11, 2012.
Vose JM. Hematopoietic stem cell transplantation. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 181.
Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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