High doses of chemotherapy or radiation cause the bone marrow to stop producing new blood cells. The new bone marrow does not recover immediately after it has been transplanted. The cells of the transplanted marrow will travel to the bones, reseed the marrow space and go through a growth process before the mature cells are released from the bone marrow into the blood stream. It will take at least eight to 14 days from the day of transplantation before your blood counts start to recover.
The term "blood counts" refers to the number of blood cells circulating in the blood stream. There are three main types of blood cells: red blood cells, white blood cells and platelets. While the bone marrow is still growing, these cells will need to be replaced through transfusions.
Engraftment is the term used to describe when your new marrow begins to function and produce cells. While awaiting engraftment, no mature cells leave the marrow and enter the blood stream. Your blood counts will show very low values and you will require careful monitoring by the health care team. The goal is to support you with red blood cell and platelet transfusions until you are producing cells again.
After transplantation, you will receive a bone marrow growth factor, called G-CSF, which will help the cells of the bone marrow grow and mature. The growth factor is given as an injection under the skin daily.
A platelet transfusion is given routinely when the platelet count falls too low to prevent serious bleeding into the tissues. You will begin to need platelet transfusions about one week after the start of chemotherapy. The number of transfusions needed per week varies from patient to patient and ranges from one to seven transfusions per week.
You will continue to need platelet transfusions for three to six weeks, sometimes longer, depending on how your bone marrow is recovering or what medications you are receiving.
There are two types of platelet transfusions:
Potential platelet donors must pass preliminary testing before donating, which involves a written history form, checking vital signs and taking a small blood sample. All persons donating blood are carefully screened for infectious diseases to make sure their blood is safe.
You may sometimes experience an uncomfortable reaction to your blood product transfusions. Some of these reactions may include fever, chills, shaking, itching and skin rashes. Infrequent side effects are back pain and shortness of breath. If you have side effects, medications are available to limit the reactions.
The red blood cells and platelets are irradiated and filtered, and frequently medications may be used before the transfusion to minimize any side effects. Your nurse will watch carefully for any of these reactions, and you should also report any symptoms to your nurse.
It is helpful if you arrange to have family members donate blood products for you to use during your hospitalization. Anyone can be a blood donor as long as they complete the blood bank screening procedures and pass all the tests.
Donations can be given at any donor center; however only donations given at Blood Banks of the Pacific in San Francisco will be available for you during your hospitalization.
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Reviewed by health care specialists at UCSF Medical Center.
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.