What Are the Risks of a Blood and Marrow Stem Cell
Transplant?
The main risks of a blood and marrow stem cell
transplant are infection, graft-versus-host disease (GVHD), and graft
failure.
Infection
You can easily get an infection after the transplant
because your immune system is weak. The risk for infection decreases as your
immune system recovers.
You can take steps to prevent infections, such as
washing your hands and staying away from crowds. Doctors use medicines to
prevent and treat infections.
Graft-Versus-Host Disease
GVHD is a common complication if you receive stem
cells from a donor. In GVHD, the new stem cells attack your body.
Acute GVHD occurs within 90 to 100 days after the
transplant. Chronic GVHD begins more than 90 to 100 days after the transplant
or goes beyond 90 days after the transplant.
GVHD can be minor or life threatening. Signs and
symptoms include:
- A rash that starts on the palms and soles of your
feet and spreads to your mid-section. Over time, the rash may cover your entire
body. Skin can blister or peel if the rash is very bad.
- Nausea (feeling sick to your stomach), vomiting,
loss of appetite, abdominal cramps, and diarrhea. Doctors determine how bad
GVHD is based on the severity of diarrhea.
- Jaundice (yellowing of the skin and eyes) and
abdominal pain, which indicate liver damage.
Medicines are used to treat GVHD. Acute GVHD is
treated with glucocorticoids, such as methyl prednisone, prednisone in
combination with cyclosporine, antithymocyte globulin, or monoclonal
antibodies.
Chronic GVHD is treated with steroidsusually
cyclosporine and prednisone on alternating days.
Older people, people who have had acute GVHD before,
and people who received stem cells from mismatched or unrelated donors are more
likely to develop GVHD.
Doctors can reduce your chances of getting GVHD
by:
- Closely matching your stem cells to your donor's
through HLA tissue typing.
- Using medicines to suppress your immune system.
- Removing T cells from donor cells. T cells attack
your body in GVHD.
- Using umbilical cord blood as the source of donor
cells.
Graft Failure
Graft failure occurs when your immune system rejects
the new stem cells. It also can occur if not enough stem cells are used, the
new stem cells are damaged during storage, or your bone marrow is damaged after
the transplant.
Graft failure is more likely in people who receive
less preparation for their transplants. People who get stem cells from a poorly
matched donor also are more likely to have graft failure.
Other Risks
Complications from chemotherapy and radiation
treatment (used to prepare for a transplant) can occur long after a transplant.
These complications include infertility, cataracts, new cancers, and damage to
the liver, kidneys, lungs, or heart. |