Recovery From Bone Marrow Transplants
- A bone marrow transplant (BMT) comes in two forms. A full transplant requires that all the bone marrow, and cancer, in a patient's body be killed using chemotherapy and radiation. After this, stem cells harvested from the patient and cleared of cancer cells are usually transplanted back into the patient. This is called an autologous transplant.
In some cases, when the patient cannot manufacture enough good stem cells, donor cells are used. This is called an allogenic transplant.
More recently, doctors have been experimenting with reducing the radiation and chemotherapy, leaving some stem cells in the bone marrow alive prior to the transplant. These mini-transplants make for a stronger patient, but may result in some serious problems during recovery. - The first major aspect of BMT recovery is ensuring the patient is kept in a sterile environment until the immune system, seriously compromised by chemotherapy and radiation, has started to recover. Two to four weeks after the transplant, the patient will be without any immune system at all. The patient may not be permitted to see guests and will eat only pastuerized foods. He or she will be kept in a room with filtered air. Once their bodies start to create new blood cells, patients may be allowed to see guests wearing sterile gowns, gloves and masks. Over time they may be allowed to leave their room as long as they wear a mask.
Once the patient leaves the hospital after 4 to 8 weeks, he or she must still remain isolated from the public to avoid infection for a period of several months. Most BMT patients will not be able to return to work for more than six months, and they may not be able to return for a year. - A patient receiving his or her own stem cells as part of a transplant procedure will not experience Graft versus Host disease (GVH). A patient receiving donor stem cells as part of a full or mini transplant is very likely to experience GVH.
Symptoms of GVH can be extreme. There is a 10 percent to 20 percent chance of dying from GVH. Symptoms include dry eyes, skin rash, jaundice, nausea, vomiting, diarrhea, and occasionally lungs and kidneys are effected.
Acute GVH usually appears in the first three months of the transplant. Chronic GVH develops three to 18 months after the transplant.
There is some indication that patients who experience GVH remain cancer free longer than those who do not.
Those who receive a mini transplant, where donor stem cells and the patients stem cells co-exist in the same body, almost invariably have GVH. - Most BMT patients experience anxiety and depression. The procedure is rigorous and painful, and the recovery long, dangerous and tedious. There are support groups for those preparing for BMT and for those in recovery. Your doctor can also help you by providing you with medication that will reduce symptoms of anxiety and depression if required.
It is important to remember that for many people with cancer, a BMT provides the best chance for a long-term recovery from cancer. Many people survive many years after a BMT, and significant percentage enjoy a normal life span cancer free.
