Your bone marrow transplant (BMT) doctor and nurse practitioner will follow you throughout your BMT procedure and experience at UCSF Medical Center. You will have blood work done and, if necessary, will be given intravenous medications or fluids.
Your risk of infection will remain higher than normal for at least three months after autologous BMT even though your body is again producing white blood cells. The highest risk is within the first month of leaving the hospital. During this period, you should spend most of your time at home and away from people — this is called house arrest.
You should not go to the supermarket, church, movie theater or any place where there may be large crowds of people. You may have visitors, but people who are ill should not visit. If there are family or household members, including kids, who are ill, you must do your best to keep away from them, either by staying in separate rooms or keeping them at a distance.
To help prevent infection, follow the guidelines below:
Your platelet count may not be back to normal levels when you are discharged. If it is low, take the following precautions:
If you have an injury that bleeds, apply pressure over the injured area. Keep applying pressure until the bleeding stops, which may take several minutes. If the bleeding does not stop, apply ice, maintain the pressure and call your clinic doctor or go to the emergency center.
Your appetite may not have returned by the time you leave the hospital, so you may have to try harder to get the calories you need. Your dietitian can help you plan meals before you are discharged. The guidelines below may help you maintain or improve your nutritional status.
Your skin will be drier than usual after treatment. Use a soap that contains a moisturizer and also use a moisturizing lotion, especially after bathing or showering. Use a crème rinse or conditioner after shampooing to moisturize your hair and scalp.
Wear a hat, long sleeves and long pants when outdoors during the day whenever possible. Always apply sunscreen (SPF 15 or higher) and limit the amount of time spent in the sun.
You may have questions regarding issues of intimacy and sexual activity after bone marrow transplantation, and should feel free to ask your doctor or nurse. Your partner also may have questions and want to be involved in any discussion.
You may feel free to hold, kiss, hug and sleep in the same bed as your partner unless your partner is ill. You may resume intercourse once your platelet count and neutrophil counts are high enough, such as a platelet count of about 50,000 and neutrophil count of about 1,500. Anal and oral intercourse may increase the risk of infection.
Many people notice a change in desire or interest in sexual activity, which is usually related to hormonal changes due to chemotherapy. This is a temporary situation and not a reflection of a change in your feelings of love or need for closeness.
The American Cancer Society (ACS) has a booklet called "Sexuality and Cancer" (one for men and their partner and one for women and their partner) which may be helpful. You can obtain the booklet from the outpatient social worker or by calling the ACS at 800-ACS-2345.
Infertility generally follows high-dose chemotherapy or TBI treatment. Sperm or egg banking should be done well before admission for transplantation if this is a concern. An interruption in the menstrual cycle is common in women, and long-term estrogen replacement may be recommended for some women. You should discuss hormone replacement with your family doctor or gynecologist.
Be aware that fertility may occur in a small percentage of both men and women after transplant. Contraception should be used to protect against unwanted pregnancy.
The appropriate time to return to work varies from patient to patient. In general, it is advised to not expect to return to work for the first year after the transplant. However, some patients are able to return to work at least part time if the work place is secluded. Check with your doctor about your expected return to work.
If you live in the San Francisco area, you may continue your follow-up and care here at UCSF Medical Center. If you are from outside the area, be prepared to return to UCSF within the first seven to 10 days after discharge following transplant, and then again at three months post-transplant. These visits will be used to evaluate how your recovery is progressing.
After three months time, you will likely be followed by your local oncologist and will return to UCSF at one year post-transplant and then yearly after that. You will be scheduled to start vaccines at one year, just like a newborn child.
Although you will be followed by your local doctor, you can always reach your UCSF health care provider for any questions by calling the clinic at (415) 353-2421.
Return to the Autologous Transplant Guide Index:
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.