Autologous Transplant Guide: Treatment and Side Effects
High dose chemotherapy
Before your stem cell transplant, you'll be given high-dose chemotherapy to kill remaining cancer cells and prepare your body to receive the stem cells. The types of chemotherapy and number of doses you receive will depend on your disease.
Your doctor will discuss all of the drugs you will receive and their side effects. Your nurse practitioner, inpatient nurse and pharmacist also will be available to answer questions. In addition, you will receive written information on these drugs in your consent meeting.
Once your treatment plan is decided, you will receive lots of education about the chemotherapy that will be administered. Medications will be provided in an effort to minimize your side effects as much as possible.
The transplant procedure
The transplant will occur after your last chemotherapy dose. The day of transplantation is referred to as Day 0. You may have a family member in the room with you during the infusion if you wish.
The transplant procedure is similar to a simple blood transfusion. The blood stem cells will be infused through your central venous catheter. Your nurse will check your blood pressure, temperature, breathing and pulse and will watch for any side effects.
Usually there are no side effects, but some patients may experience a funny taste in the mouth, chills, flushing of the face, nausea and vomiting, headache and changes in blood pressure and breathing. Your urine also may be tinged red for the first 24 hours after transplantation. If your urine remains red after this time or becomes red later, tell your nurse.
Delayed side effects
You may feel the effects of the chemotherapy about a week after transplantation. When your blood counts are low, you will feel fatigued. You may feel like you have the flu and may not want to do much. This will last for about two weeks and will lessen as your blood counts improve. Other side effects may include:
Infection
Infection is one of the most common complications when the white blood cell count is low. However, after it returns to normal, resistance to infections is still decreased, partly due to the medications you will be receiving and partly due to the time it takes for your new immune system to grow. We will be monitoring the re-growth of your immune system and will notify you as your risk of infection decreases.
Antibiotics and other anti-infection drugs will be administered to prevent infections. You will continue to take them upon discharge from the hospital to help prevent infection.
Infections can occur anywhere in your body. It is very important to report any signs or symptoms of an infection to your nurse or doctor. Signs and symptoms include:
- Chills and/or fever
- Shortness of breath, coughing and the production of sputum (a mucus-like secretion)
- Loose, watery stools or stomach pain
- Blisters, rashes, mouth sores, sores or redness at a catheter site and irritation or sores around the vaginal or rectal area
- Headache or inability to bend your neck forward
- Sore throat, difficulty or pain in swallowing, toothaches and earaches
- Pain during bowel movements or urination
- An infected hangnail or skin around the toenails or fingernails, including any redness or swelling
Nausea and vomiting
Chemotherapy and sometimes antibiotics may cause varying degrees of nausea and/or vomiting. Your care team will order medication to control the nausea and vomiting.
Some foods, especially the odor of hot foods, may increase the nausea or vomiting. If this occurs, it is best to try to avoid these for several days and select only those foods that make you more comfortable, such as cold foods and beverages. Avoid greasy foods and eat small, frequent meals instead of large amounts.
Loss of appetite
Appetite loss occurs frequently. Avoiding foods that cause discomfort or sometimes not discussing eating and food can help. Try to eat small amounts but more frequently – become a nibbler. Eat what you have cravings for and don't eat what is not appealing. Your appetite will begin to improve when your blood counts get better.
Chemotherapy and some medications may cause temporary changes in your sense of taste and sometimes your sense of smell. Many patients state that suddenly food tastes like paper or cardboard. Most patients find their sense of taste begins to recover by the second or third week after chemotherapy, but full recovery may take months.
Diarrhea
Chemotherapy and some antibiotics may cause diarrhea. This can lead to skin breakdown and infection around the rectum. A stool sample may be collected to rule out infection as a cause of diarrhea.
Medications are available to decrease diarrhea, and creams or sitz baths may soothe the irritation around the bottom. Please let your care team know if you are having any discomfort around your bottom.
Hair loss
Hair loss generally occurs one to two weeks after chemotherapy. This is temporary and the hair is expected to grow back. We recommend shaving or cutting your hair very short to prevent itching when there is hair loss.
Wigs are not recommended during your hospital stay, because they cannot be cleaned properly, but you may want to purchase a wig or hairpiece after you are discharged. These are tax-deductible medical expenses. Some medical insurance covers these costs.
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UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.