Bone marrow transplant – children - discharge


Alternative Names

Transplant - bone marrow - children - discharge; Stem cell transplant - children - discharge; Hematopoietic stem cell transplant -children - discharge; Reduced intensity, non-myeloablative transplant - children - discharge; Mini transplant - children - discharge; Allogenic bone marrow transplant - children - discharge; Autologous bone marrow transplant - children - discharge; Umbilical cord blood transplant - children - discharge

What to Expect at Home

Your child had a bone marrow transplant. It will take 6 to 12 months or more for their blood counts and immune system to fully recover. During this time, their risk of infection, bleeding, and skin problems is higher.

Their body is still weak. It may take up to a year for your child to feel like they did before their transplant. They will likely get tired very easily. They may also have a poor appetite.

If they received bone marrow from someone else, they may develop signs of graft-versus-host disease (GVHD). Ask their health care provider to tell you what signs of GVHD you should watch for.

Preventing Infections

Take care that your child does not to get infections for 1 year or more after their transplant.

Make sure your child follows guidelines for safe eating and drinking during her cancer treatment.

Make sure your child washes their hands with soap and water often, including:

Ask the doctor what vaccines your child may need and when to get them.

Oral Care

Your child's immune system is weak. So it is important to take good care of your child's oral health. This will help prevent infections that can become serious and spread. Make sure your child's dentist knows that your child has had a bone marrow transplant. That way you can work together to ensure the best oral care for your child.

Take care of your child's braces, retainers, or other dental products:

General Care

If your child has a central venous line or PICC line, be sure to learn how to take care of it.

Take care when your child plays with toys:

Be careful with pets and animals:

Resuming schoolwork and returning to school:

Follow-up

Your child will need close follow-up care from the transplant doctor and nurse for at least 3 months. At first, your child may need to be seen weekly. Be sure to keep all appointments.

When to Call the Doctor

If your child tells you about any bad feelings or symptoms then call your child's doctor. A symptom can be a warning sign of an infection. Watch for these symptoms:

References

American Academy of Pediatric Dentistry. Guideline on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation. Pediatr Dent. 2013 Sep-Oct;35(5):E185-93. PMID: 24290549 www.ncbi.nlm.nih.gov/pubmed/24290549.

Bashir Q, Champlin, R. Hematopoietic stem cell transplantation. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadeplphi, PA: Elsevier Saunders; 2014:chap 30.

Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). School-aged and adolescent bone marrow transplant (BMT) recipients: quality of life interventions. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; May 30, 2012. www.guideline.gov/summaries/summary/37634/best-evidence-statement-best-schoolaged-and-adolescent-bone-marrow-transplant-bmt-recipients-quality-of-life-interventions. Accessed August 30, 2016.

National Marrow Donor Program. Living Now: A Guide to Life After Transplant. Updated May 2015. bethematch.org/workarea/downloadasset.aspx?id=1284. Accessed August 30, 2016.

Velardi A, Locatelli F. Principles and clinical indications of hematopoietic stem cell transplantation. In: Kliegman RM, Stanton BMD, St Geme J, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 135.


Review Date: 8/31/2016
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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