Bone marrow transplant (BMT) provides healthy stem cells to replace cells lost to chemotherapy, radiation or disease. When the new cells are infused at transplant, it allows the bone marrow to produce healthy stem cells and attack any cancer cells left in the body. Complications of BMT may range from mild to severe, depending on the type of transplant. Using the patient's own stem cells (autologous transplant) has fewer complications than using a relative or non-related person's stem cells (allogeneic transplant).
Infection and Bleeding
Without stem cells, the body can't control bleeding or fight infection. It may take weeks after the transplant for the body to produce healthy red blood cells, platelets and white blood cells. Blood tests are used to monitor response to the transplant. Anemia (not enough red blood cells to carry oxygen) and bleeding may be treated by blood and platelet infusions. Antibiotics may be used to prevent or treat infection. Strict hand washing and other measures such as isolation in the hospital or limited contact with people are also used to minimize the risk of infection.
Common Complications
Lack of energy, loss of appetite, nausea and vomiting are common complications. Mouth sores, hair loss and skin reactions may occur. These complications are usually short-term and may be treated with transfusions, special diets, drugs, mouthwashes and other treatments depending on the complication. Rest and gentle exercise, if allowed by the doctor, may increase energy levels. Complications vary with the type of transplant used.
Graft Versus Host Disease
When stem cells from a relative or unrelated person (the donor) are used instead of the patient's own cells, graft versus host disease (GVHD) may develop. GVHD occurs when the donor's white cells attack the patient's body in areas such as the skin, intestines and liver. Abdominal pain, diarrhea, yellowing of the skin (jaundice) and skin rash are some side effects. This complication can be acute, within the first 90 days after receiving cells, or chronic, occurring more than 90 days after the transplant. Drugs such as high-dose steroids or others that suppress the immune system are used. Other treatment depends on the side effect. GVHD can be managed, but if severe, it may result in death.
Long-Term Complications
Before the transplant, high-dose chemotherapy and radiation are used to prepare the body to accept new stem cells. Complications may include loss of eyesight from cataracts, the inability to have children and permanent damage to body organs from the pre-transplant treatments. Damage to body organs from GVHD may also require long-term medical care.
