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.
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.
You need to take care not to get infections for up to 1 year or more after your transplant.
Wash your hands with soap and water often:
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.
Ask your doctor what vaccines you may need and when to get them.
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.
If you have any of these symptoms, call your doctor:
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
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.
Updated by: 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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