Initial Side Effects
For the first two weeks after your transplant, you may experience some of the side effects of the radiation and chemotherapy. About one week after transplant, your hair will begin to fall out. You may also experience occasional diarrhea and vomiting. There is a chance you may develop mucositis, or painful sores in the mouth. There may be a skin rash as well. There are many medications that may be given to you to control these side effects. Most side effects resolve within the first two to three weeks. Hair usually begins to grow back within four to twelve weeks.
For the first few weeks post-transplant, you may not feel like eating. Central venous nutrition or CVN will be given through your catheter to supply all the nutrients that you need. Because this can be a very stressful time for you, both emotionally and physically, your caloric needs are increased. We do not want you to lose weight during this time and CVN helps to prevent this. Some patients eat throughout their hospital stay, before and after transplantation, and require little or no CVN.
Following a stem cell transplant, most patients feel that they don't have the stamina they used to have. It may be difficult for you to participate at the same level in activities and as a member of your family as you did prior to hospitalization. You and your family need to understand that there is both an emotional and physical recovery from transplantation. We recommend patients wait six to 12 months after their transplant to return to work or school.
Stem cell transplantation may result in major changes for the immune system. For patients who received their own cells (autologous) for transplant, these changes are relatively minor.
Autologous transplant patients will have a weakened immune system for a number of months, with immunity being restored much as it has been. Resistance to childhood diseases that had previously occurred will be re-established. Since most adults have allowed tetanus immunity to fade, we do recommend that one or two tetanus boosters be given a year or so after the transplant.
For patients receiving a donor cell (allogeneic) transplant, the immunity of the donor eventually (within one to two years) becomes the immunity of the recipient. Since most adults have had the common childhood diseases, the recipient's immunity against these diseases is carried on after the transplant in the form of the donor's immunity. As with autologous transplant patients, we do recommend re-immunizing with tetanus after all immunosuppressive medications have been stopped and at least one year from transplant has elapsed.