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Discharge Instructions for Bone Marrow Transplant

You received healthy blood stem cells. They will work to grow healthy bone marrow and healthy blood cells. It will take about 6 months for the body to make enough new blood cells. Until then, you have a higher risk of infection. Here are some steps that can help.

Steps to Take

Self Care

To prevent infection, wash your hands often. Do this especially:

  • After touching common items and surfaces
  • After touching pets
  • If you have been outdoors
  • Before and after making food
  • Before eating or taking pills

Other steps to reduce the risk of infection are:

  • Follow the care team plan for wearing a face mask.
  • Avoid crowds and contact with sick people.
  • Wipe down kitchen and bathroom surfaces often. Hire someone to clean germy areas. Vacuum often.
  • Do not do lawn work or gardening. Do not handle soil, potted plants, or fresh flowers.
  • Do not handle pet waste.
  • Avoid smoke or dusty air. Stay away from new construction.
  • Avoid swimming in public pools, hot tubs, or natural bodies of water.

To prevent infections or sores in your mouth:

  • Brush your teeth 2 to 3 times per day. Use a soft bristle brush and fluoride toothpaste.
  • Rinse your mouth after each meal. Do not use alcohol-based mouthwash.
  • Keep dentures or other devices clean.

When possible, others in your house should check their vaccine status.

What to Eat

You may not feel like eating. Try smaller, more frequent meals. Supplement drinks may be needed until you feel better. During recovery:

  • Drink plenty of fluids. Water is the best choice. Avoid sugary drinks.
  • Tap water is okay unless it is well water. Use bottled water instead of well water.
  • Do NOT eat :
    • Raw vegetables, meats, or fish like sushi
    • Foods from salad bars or buffets
  • Eat easily digested, freshly cooked foods.
  • Cook egg yolks until they are firm or hard. Cook meats to well or medium-well.

Activity

You may feel tired. Balance activity and rest. Increase activity as you feel able. Also:

  • Do not do activity with a high risk of injury.
  • Return to work and drive when your doctor says it is okay.
  • Do not have sex unless your doctor says it is okay. When you do have sex, you may need to use protection.

Medications

You may need to avoid certain medicine. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) make it easier to bleed. Follow your care team's advice before taking any medicine, including over-the-counter medicine.

Medicine may be needed to help your body accept the new cells.

When taking medicine:

  • Take your medicine as advised. Do not change the amount or schedule. Take your medicine as directed. Do not change the amount or the schedule.
  • Be aware of the side effects of your medicine. Tell your doctor if you have any.
  • Do not stop taking prescription medicine without talking to your doctor.
  • Do not share your prescription medicine.
  • Medicines can be harmful when mixed. Talk to your doctor or pharmacist if you are taking more than one. This includes over the counter products and supplements.
  • Plan for refills.

Other Steps That May Help

It is common to feel anxious or isolated during recovery. Talk to your care team about your concerns. Stay in touch with friends and family. A support group may also help.

Follow-up

You will be in close contact with your care team. Regular tests will help to guide your treatment plan. Be sure to go to any advised appointments.

Problems to Look Out For

Call your doctor if you are having problems managing your condition or you have:

  • Signs of infection, such as sore throat, stuffy nose, fever, and chills
  • Redness, swelling, excessive bleeding, or any discharge from the injection or incision site
  • Nausea, vomiting, or diarrhea
  • New pain or pain that you cannot control with the medicine
  • Problems with urination
  • Cough, shortness of breath, or chest pain
  • Joint pain, fatigue, stiffness, or rash
  • Worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

Be the Match
https://bethematch.org

Bone & Marrow Transplant Information Network
http://www.bmtinfonet.org

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Cancer Care Ontario
https://www.cancercare.on.ca

REFERENCES:

Blood-forming stem cell transplants. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant/stem-cell-fact-sheet. Accessed April 16, 2021.

Bone marrow transplantation. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed April 16, 2021.

Learn about transplantation as a treatment option. US Health Resources and Services Administration website. Available at: https://bloodcell.transplant.hrsa.gov/transplant/understanding_tx/index.html. Accessed April 16, 2021.

Stem cell transplant for cancer. American Cancer Society website. Available at: http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/bonemarrowandperipheralbloodstemcelltransplant/bone-marrow-and-peripheral-blood-stem-cell-transplant-toc. Accessed April 16, 2021.

Last reviewed March 2021 by EBSCO Medical Review Board Mohei Abouzied, MD