You have had a bone marrow transplant. It will take 6 months or more for your blood counts and immune system to fully recover. During this time, your risk of infection, 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 transplant. You will likely get tired very easily. You may also 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 once 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 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.
Do not eat foods and drinks that have a lot of sugar in them. Chew sugarless gums or suck on sugar-free popsicles or sugar-free hard candies.
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.
- To kill germs, soak your dentures in an antibacterial solution when you are not wearing them.
Take care not to get infections for up to 1 year or more after your transplant.
- 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, fish, or anything else you are not sure is safe.
Wash your hands with soap and water often:, including:
- 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 not to 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 your cat's 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.
- If you have a central venous line or PICC line, know how to take care of it.
- If your doctor or nurse tells you your platelet count is low, learn how to prevent bleeding during cancer treatment.
- Stay active by walking. Slowly increase how far you go based on how much energy you have.
- Eat enough protein and calories to keep your weight up.
- Ask your doctor about liquid food supplements that can help you get enough calories and nutrients.
- Be careful when you are 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. Be sure to keep all your appointments.
When to call the doctor
Call your doctor if you have any of these symptoms:
- 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.
- Pain in your abdomen.
- Fever, chills, or sweats. These may be signs of infection.
- A new skin rash or blisters.
- Jaundice (your skin or the white part of your eyes 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.
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
Be The Match. Post-transplant care guidelines. http://bethematch.org/For-Patients-and-Families/Support-and-resources/Educational-resources/Survive-resources.Accessed May 7, 2014.Be The Match. Post-transplant care guidelines. http://bethematch.org/For-Patients-and-Families/Support-and-resources/Educational-resources/Survive-resources. Accessed May 7, 2014.
Bishop MR, Pavletic SZ. Hematopoietic stem cell transplantation. In: Abeloff MD, Armitage JO, Niederhuber JE, et al., eds. Abeloff's Clinical Oncology. 4th ed. Philadelphia, PA: Elsevier Churchill-Livingstone; 2008:chap 32.
Vose JM. Hematopoietic stem cell transplantation. In: Goldman L, Schafer AI. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 181.
- Bleeding during cancer treatment
- Central venous catheter - dressing change
- Central venous catheter - flushing
- Diarrhea - what to ask your doctor - child
- Diarrhea - what to ask your health care provider - adult
- Drinking water safely during cancer treatment
- Dry mouth during cancer treatment
- Eating extra calories when sick - adults
- Eating extra calories when sick - children
- Oral mucositis
- Peripherally inserted central catheter - flushing
- Safe eating during cancer treatment
Update Date 5/7/2014
Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.