Side effects of a stem cell or bone marrow transplant

Many of the problems may soon arise after the transplant due to the bone marrow getting wiped out by medicines or radiation just before the transplant. Other side effects may arise due to the treatment. But your transplant team can help you cope with certain side effects. Some side effects can be treated while some can be prevented to make you feel better. 

Bone marrow or stem cell transplant is the procedure to replace the damaged bone marrow with healthy cells. Some side effects are permanent while some go away with time. Managing side effects is part of the treatment procedure. It is called supportive or palliative care. 

Cancer treatment in India is much lower when compared to other western countries in the world. Below we have listed certain side effects of stem cell or bone marrow transplant, but this is not a complete list of side effects. If you notice any of the following please bring it to your doctor’s notice as some of these side effects can be life threatening. 

Side effects of bone marrow transplant: 

  • Mouth and throat pain
  • Nausea and vomiting
  • Infection
  • Bleeding and transfusion
  • Interstitial pneumonitis and other lung problems Graft-versus-host-diseases
  • Hepatic Veno-occlusive disease 
  • Organ damage
  • The cancer may come back
  • New cancer
  • Abnormal growth in lymph nodes 
  • Infertility in women 
  • Hormonal changes 
  • Cataract 
  • Fatigue 
  • Low level of platelet, white blood cells and red blood cells

How much does a bone marrow transplant cost? Bone marrow transplant cost ranges from 15,00,000 to 40,00,000 in India. The actual cost will depend on which BMT treatment has been suggested for you. Allogeneic and autologous are the most common bone marrow transplant treatments that are prescribed to treat cancer. 

Side effects of Bone Marrow or stem cell transplant:

  1. Mouth and throat pain:

Sores in mouth is a short term side effect that may arise because of radiation or chemotherapy. It happens after a few weeks of the treatment and can make it more painful to eat and drink. Good nutrition is important for people with cancer. Your transplant team may help you to cope with symptoms of mouth sore as good nutrition is vital for the body. 

  1. Nausea and Vomiting:

Chemotherapy gives severe nausea and vomiting, hence doctors often give anti nausea medicines at the same time as chemotherapy to prevent it. It is easier to prevent nausea and vomiting rather than to stop it. Chemotherapy causes vomiting which lasts for 7 to 10 days, hence prior to chemo your doctor should start with preventive treatment and continue after the chemo until the last dose. 

No one medicine can help prevent nausea and vomiting hence more than two medicines are prescribed to prevent it. You need to tell your doctors, how well the medicine is working for you so that they can change if it doesn’t work at all. 

  1. Infection:

After the transplant at least for 6 weeks, until your body starts making white blood cells, your body is likely to get an infection. The bacterial infection is most common during this time but viral infections controlled by your immune system can become active again. You may also catch fungal infections easily. This is because your body doesn’t have enough white blood cells that can fight these infections. Until your blood count reaches its optimum level, you will be given antibiotics to prevent infection. As your immunity will be low, you need to closely watch out for infections such as fever, diarrhea, shortness of breath, and cough. Extra precautions will be taken to prevent exposure to germs.   

  1. Bleeding and transfusions:

The transplant treatment destroys your body’s ability to make platelets which cause bleeding in the body. Platelets are the blood cells that make clots in the body. Until the transplant stem cells start functioning properly, your transplanted team may provide special precautions to avoid bleeding and injury. 

After the transplant, platelet counts are really low. You may notice nose bleeding, gum bleeding, or easy bruising. You will need to follow certain precautions until your platelets reach their safest level. 

  1. Interstitial pneumonitis and other lung problems:

Pneumonitis is swelling in lung tissue which is very common immediately after the transplant. Some lung problems may first show in 100 days of transplant while some may show in 2 or more years after the transplant. Pneumonitis is caused by radiation, chemotherapy or graft versus host disease. It’s caused by damage to the areas between the cells of the lungs. 

If you notice shortness of breath, please bring it to your doctor’s notice immediately. 

  1. Graft versus host disease:

Graft versus host disease (GVHD) can happen in allogeneic bone marrow transplant when the immune cell from the donor sees it as a body of a foreign. The donor’s immune cells may attack the organs, liver, skin, and gastrointestinal tract. This may increase the chances of infection. These changes are hardly noticeable and may be life-threatening as well. GVHD can be chronic as well as acute. Acute GVHD starts after the bone marrow transplant and lasts for a shorter time while chronic GVHD starts later and lasts a longer time. A person may have one or both or neither of the GVHD.  

You will get the best cancer treatment in India at Apollo hospitals situated in Hyderabad, Bengaluru, Chennai, Kolkata, Delhi, Bhubaneshwar, Ahmedabad, Madurai, and Bilaspur. 

  1. Hepatic veno-occlusive disease (VOD):

VOD is a serious problem where tiny veins and other blood vessels inside the liver get blocked. This is not a common side effect and may happen in people with an allogeneic transplant, and mainly in drugs melphalan or busulfan as part of their treatment which was given before the transplant. It happens within weeks of the transplant. It is common in older people and people who had liver problems before the transplant. VOD is life-threatening, hence early diagnosis is vital. 

  1. Graft failure:

The graft can fail when the body doesn’t accept the new stem cells. Graft failure is common with patients whose donor is not well matched and when the patient gets stem cells that have the T-cells removed. It is very common in patients who get a low number of stem cells such as a single umbilical cord unit. It can lead to serious bleeding or infection. Grafts rarely fail, but if they do fail can result in the death of the patient. 

How much does a bone marrow transplant cost? The cost of bone marrow depends on many factors such as the type of transplant and location of the bone marrow transplant. Your doctor will then give you an estimate of the bone marrow transplant cost. The cost is much lesser in India compared to other western countries in the world. 

There are other side effects of stem cell transplants. The problems are influenced by many factors such as type of transplant, patient’s overall health, chemo or radiation treatment, age of the patient, and several other factors. Long-term risk of bone marrow transplant may include organ failure, relapse, secondary cancers, abnormal growth in the lymph nodes, infertility, cataract, and hormonal changes.