The days following the transplant are counted as day 1, day 2, and then on. This method can be used to explain the exact timing of events like when new blood cells start to appear or when issues arise.
The process of enlargement
Engraftment occurs in the process where transplanted stem cells get into the bloodstream and make their way into the bone marrow and begin to make the new cells for blood. It generally takes between 2 to 6 weeks before you begin to see a steady increase back to the normal level of blood count. It is likely that you will be admitted to the hospital for a portion of this period.
At this point, you might feel exhausted and generally sick. The risk is infections, fever, bleeding and anemia, injury to organs, as well as food-related issues. Many of these conditions occur when your blood count is extremely low, typically 2 to 3 weeks following the transplant.
You will be placed in a private room in the hospital due to the higher risk of getting sick. You'll be subject to regularly scheduled blood tests as well as check-ups on your temperature. You will be closely monitored for signs of nausea, bleeding vomiting, diarrhea or any other health issues.
The bone marrow isn't creating new blood cells, you could:
- You can receive medicines such as antifungals, antibiotics as well as antivirals, to prevent and manage diseases.
- require the transfusion of blood as well as platelet transfusions
- You can be prescribed medicines to avoid the disease graft-versus-host.(GVHD)
- Be given colony-stimulating agents
to speed up the healing process and decrease the time count of the blood vessels is low
You could receive nutritional supplements and nutrition through an artery in the central vein (catheter) (called
Parenteral nutrition, also known as total parenteral nutrition(TPN) until you are able to consume food through your mouth, and any problems like vomiting, nausea, and mouth sores go completely.
The hospital discharge
A bone marrow test show how blood cell counts start to increase when the new cells for blood are produced. If this happens and there is no problem then you might be able to go home or relocate near to the center for transplants. It is important to stay close in the event that you experience problems and have to return to the hospital.
Most transplant centers don't let you home following the procedure unless you satisfy the following requirements:
- You haven't had an illness for more than 48 hours.
- You've been able to take pills and stay on them for up to 48 hours.
- Your symptoms, like diarrhea, nausea, and vomiting can be controlled by taking medicine.
- You can consume food and drink sufficient fluids.
- You are in a safe range of blood cells.
- There is someone who can help you at your home.
If you don't satisfy these requirements then you could be transferred away from the hospital's transplant center to a different location in the hospital.
After you are discharged from the hospital ensure that you adhere to the guidelines for taking care of yourself at home.
Recovery
It can take longer for the bone marrow to heal following an allogeneic transplant than it does after an autologous and, consequently, the hospital stay can be longer. This is because an allogeneic transplant is a complex procedure that makes use of stem cells donated by the donor rather than the stem cells you have. Certain patients may have to remain in the hospital for a longer period if there are problems. The recovery process is contingent on your physical health prior to the transplant as well as the possible adverse effects you experience.
A majority of people won't experience any serious issues after leaving the hospital, however, it could take up to a year for them to recuperate. It is possible to feel exhausted and weak for a few months. It can be difficult to adjust emotionally due to the length of time you are sick and the fact that you are far from others while in hospital due to the risk of illness. It is possible to experience strong emotions of depression, anxiety, and anger, yet you may also be happy and excited.
Discuss with the healthcare team your concerns and feelings. Your caregiver and you will receive instructions and guidance on caring yourself at home, for example:
- Making your home secure and preparing it to secure
- food and nutrition, and what you should and shouldn't
- Activities that you can and shouldn't perform
- How to take care of your teeth and mouth
- when to contact the transplant team as well as other members on the team for healthcare
Follow-up
There will be frequent checks and tests following the stem cell transplantation until the bone marrow is working well and there aren't any significant issues.
First 3 Months
In the first three months following the discharge from the hospital, You will be monitored every day or every other week or every two months until blood counts are back to normal. In this period, you are likely to see the following signs:
- Regular blood tests are conducted to measure the blood cell count.
- It is recommended to continue taking medicines to decrease the chance of contracting an infection.
- You have prescribed drugs to reduce the immune system and decrease the chance of GVHD in the event of an allogeneic donor.
- There are many reasons to have transfusions of platelets or blood.
- It's possible that you need to visit the hospital if you are feeling unwell or have signs such as fever, skin rash severe diarrhea, or breathing difficulties.
- Avoid crowds and contact with children who've recently been exposed to diseases that are infectious (such as chickenpox) or who have been immunized with live viruses (such as a specific vaccine against polio).
- Wear an alert card for medical emergencies necklace, bracelet, or pendant.
After 3 months
After three months after 3 months, the doctor will determine the frequency at which follow-up visits should be conducted. If there aren't any significant issues, follow-ups could be less frequent as time goes by and the risk of complications decreases.
Your overall health and how the bone marrow functions will be assessed. It is possible that you will need to alter your medication and lifestyle. The healthcare team will discuss your concerns and issues with your healthcare provider.
If you are not experiencing any problems then you'll need to attend a follow-up appointment once each year by your family physician or your primary oncologist. There are times when you may need to visit an institution for transplants.
At the end of the first year, the immune system typically returns to normal, and the bone marrow starts producing blood cells in a normal way. It could take longer for some individuals particularly if they are taking immune-suppressing medications.
Around 1 to 2 years following organ transplantation the majority of people must be given vaccines commonly administered during childhood (such as measles and polio). Healthcare professionals will talk to you about which vaccinations you should receive to strengthen your immune system.
