A bone marrow transplant comes with many risks; however it has saved many lives from leukemia, severe aplastic anemia, Hodgkin's disease, myelodysplastic syndromes and non-Hodgkin's lymphoma. According to the National Marrow Donor Program, the first 100 days from the bone marrow transplant are the most critical when in comes to developing infections.
Veno-oclusive disease
Veno-occlusive disease, VOD, occurs within the first month after the transplant and is caused by the preparative regimen of chemotherapy and possibly radiation. VOD causes the liver to swell, which blocks blood flow and the liver cannot empty waste from the bladder. According to the National Marrow Donor Program, symptoms include yellowing of the skin and eyes, pain in the patient's upper right abdomen and weight gain. Treatments include a blood transfusion, switching drugs, kidney dialysis, a low salt diet and preventing blood clots via medication.
Lung Damage
During the preparative regimen, the chemotherapy and radiation can damage the patient's lungs, making it difficult to breathe. Damage to the lungs can be mild to severe. Those with a mild case are placed on oxygen, while those with a severe case may need a ventilator to breathe for him or her. According to the National Marrow Donor Program, steroids can be given to help to improve lung function. However, the doctor will have to run tests to determine the cause of the damage and the course of treatment.
Infections
After the preparative regimen of chemotherapy and possibly radiation, the patient's immune system is very weak and cannot fight off bacteria, fungal or viral infections. According to the National Marrow Donor Program, most infections emerge within the first 100 days after transplant. Places where infections are common include the site of the central line, mouth, lungs, urinary tract, the rectum or around the rectum and the patient's blood. The patient will take antibiotics to help to prevent infections while in the hospital and when she is discharged.
Graft-versus-host disease
There are two types of transplants, autologous and allogeneic. Autologous transplants use the patient's cells. An allogeneic transplant uses cells from a donor. Graft-versus-host disease, or GVHD, is common after an allogenetic transplant. The immune cells from the donated marrow attack the patient. When GVHD occurs during the first 100 days after transplant, it is considered acute, if GVHD occurs after the first 100 days, it is considered chronic. According to St. Jude Children's Research Hospital, acute GVHD symptoms include yellowing of the skin and eyes, diarrhea and rash. Chronic GVHD symptoms include dry eyes and mouth, ulcers in the mouth or on the skin, inability to move joints easily, difficulty with swallowing, a white film in the mouth and swelling of the eyes. Treatment for both acute and chronic GVHD is steroid therapy.
Graft Failure
Graft failure is rare and occurs in about 5 percent of transplants, according to the National Marrow Donor Program. Graft failure occurs when the donated cells do not make new red blood cells, white blood cells or platelets after 42 days from the transplant. The only treatment for graft failure is undergoing another bone marrow transplant, either from the same donor or from a different donor. Patients who have received cells from cord blood cannot receive them again from the same donor cord and can try a human donor.
