Stem Cell Transplant Treatment Side Effects

Stem cell transplants (also known as bone marrow transplants) are used to introduce blood-forming stem cells into your body to replace bone marrow cells that are not making enough healthy blood cells. Stem cell transplants may use cells from your own body or from a donor.

A stem cell transplant may be used to:

• Safely allow high-dose chemotherapy or radiation by restoring or rescuing the bone marrow that cancer treatment has damaged.
• Substitute bone marrow that isn't working properly with new, functional stem cells.
• Infuse your body with new stem cells to help eliminate cancer cells directly.

Stem cell transplants may be used to treat cancers that affect the blood and lymphatic systems, hereditary blood disorders and autoimmune diseases. They can also help patients recover from or tolerate cancer treatments such as chemotherapy and radiation more effectively.

Before the transplant, your doctors will need to prepare your body to receive the new stem cells. This is called the preparative or conditioning regimen. It consists of chemotherapy and radiation given several days before your transplant. This step destroys your diseased cells and suppresses your immune system, allowing the healthy blood stem cells to begin producing new blood cells.

Following a stem cell transplant, it will take a few weeks for the transplanted stem cells to start making healthy blood cells. This is called engraftment.

What are the side effects of a stem cell transplant?

Your risk for side effects depends on various factors, including the illness or condition requiring the transplant, the kind of transplant, your age and your general health. Side effects are most severe immediately after chemotherapy and can last for several weeks. You'll begin to feel better once your blood counts start to rise.

Stem cell transplant side effects can be caused by the chemotherapy given as part of the preparative  regimen or by the transplant itself. They include:

• Infections: Following treatment, transplant patients’ immune systems are more vulnerable, so they must take precautions, which may involve using medications like antibiotics.
• Increased risk of bleeding: Your platelet count will decrease following your treatment. Since platelets are essential for blood clotting, a low level means a higher risk of bleeding. You may find yourself bruising more easily than normal.
• Anemia: After treatment, your red blood cell count will drop, and your transplant team will monitor it daily. If it becomes too low, you may feel low on energy or breathless. Some patients may require a blood transfusion to treat persistently low red blood cell counts.
• Fatigue: You'll likely experience significant fatigue after your transplant, particularly during the second and third weeks when your blood cell counts are lowest. Over time, you'll start to regain energy, but expect to feel more tired than usual for an extended period after the transplant, potentially lasting up to a couple of years.
• Hair loss: Most cancer patients who receive chemotherapy or radiation therapy before a stem cell transplant will experience at least some hair loss during their treatment. Hair should regrow after chemotherapy treatment ends.
• Weight loss: Cancer and its treatments can change how food tastes and smells, reduce appetite and impact patients’ ability to eat or absorb nutrients. Nearly all stem cell transplant patients will have side effects that make eating and drinking harder.
• Nausea & vomiting: Many chemotherapy drugs and radiation cause nausea (upset stomach), but there are medicines to prevent nausea and vomiting. You can either take medicines by mouth or intravenously (through a vein) when you have chemotherapy before a stem cell transplant.
• Diarrhea: Loose, watery and possibly more frequent bowel movements are common stomach and intestinal problems in patients undergoing stem cell transplantation. The worst of the diarrhea usually happens in the first few weeks after the transplant.
• Mouth sores: After a stem cell transplant, it’s very common to experience a sore mouth and mouth ulcers. Mouthwashes and lozenges can help prevent infections. Sucking on ice cubes may also provide some relief.
• Graft versus host disease (GVHD): This condition occurs when the body’s immune cells attack cells from the donor, or when the donor cells attack your cells. GVHD can occur right after the transplant or more than a year later. Immunosuppressant drugs may help to reduce the reaction. There are two main types of GVHD:
  • Acute graft versus host disease: Usually occurs within the first 100 days of your transplant but symptoms may develop later. Most often it affects your skin, gastrointestinal tract or liver.
  • Chronic graft versus host disease: Can appear any time after a transplant, but most cases typically start within two years. It can affect your skin, mouth, liver, lungs, gastrointestinal tract, muscles, joints or genitals.
• Loss of fertility: A long-term side effect of a transplant is infertility, which prevents you from conceiving or fathering a child naturally. This can result from whole-body radiation and high doses of chemotherapy. Though rare, some transplant recipients do have children naturally. For women, the treatment can also induce early menopause. There are some options for men and women to preserve fertility before stem cell transplant treatment.

When to call your cancer care team about side effects

Following a stem cell transplant, you will need to regularly follow up with your doctor so they can monitor how your body and immune system are responding to the treatment. While many side effects are temporary, others may indicate serious problems. Contact your care team if you have any of the following symptoms during treatment:

• A fever higher than what your cancer care team has instructed
• An allergic reaction
• Intense chills
• Pain at your injection site or catheter site
• Long-lasting diarrhea or vomiting
• Blood in your stool or urine

Learn more about stem cell transplant treatment.