When a decision is made about the eligibility for bone marrow transplantation, the most important factor is the presence of controlled disease. Other factors that require consideration are absence of infections and functioning of vital organs.
The optimal timing of bone marrow transplantation varies for each disease. For acute leukemia that are characterized by poor risk factors, it is employed immediately after the disease is controlled; it is used in the second disease control that is achieved after the recurrence in many lymph cancer and after the disease control in multiple myeloma. However, these conditions are influenced by certain factors, such as availability of stem cell donor, type of transplantation, the extent the disease is controlled, risk factors and overall health of the patient. The best timing and the type are decided by the transplantation team and notified to the patient, who is also informed about the possible benefits and potential risks.
There are overall age limitations recognized for the bone marrow transplantation, but the overall health of the patient is more important than the age. Even if the age of the patient allows transplantation, the dysfunctions of the vital organs may contraindicate the transplantation, and the age may not be an important barrier especially for the candidates of autologous transplantation.
After chemotherapy is administered to prepare the patient for the transplantation, the prerequisite for the success of the transplantation is the maturation of the stem cells to produce blood cells. This period usually lasts 10 to 20 days depending on the type of transplantation, the preparation regimen and the quality and count of stem cells as well as the overall health of the patient. Mean length of stay in the transplantation unit is 2 to 4 weeks in average.
Depending on the conditioning regimen performed for bone marrow transplant, the patient may face infertility after the transplant procedure. This fact and potential solutions, such as storage of sperm or egg, are informed to the patient by the transplant doctor before the transplantation.
The most important problems a bone marrow recipient can face are infections, hemorrhage and rejection of the transplanted bone marrow. Throughout the hospital stay of the patient, the transplant team will take all measures, especially including a very specialized room, to combat such problems. Before conditioning chemotherapy is started for the patient, prophylactic antibiotic treatment is given to prevent infections and the patient is closely monitored regarding potential signs of infection. If an infection develops, it is treated with intravenous antibiotics.
Most common sources of infection;
Risk of bacterial infection decreases after the bone marrow starts functioning in the recipient. However, patient’s immune system will be suppressed by and due to chemotherapy, radiotherapy and other medications for several weeks. This interval may vary depending on the type of bone marrow transplant and the conditioning regimen. The risk of infection, especially viral and fungal ones, will persist within this period. If a catheter is left in the body after the patient is discharged, the risk of infection, particularly bacterial infections, will continue.
Proper nutrition not only improves your immune system, but it also strengthens your body. You may need foods with higher protein or calorie than you get used to after the bone marrow transplant. Moreover, there are some foods you need to avoid for combating the risk for infection. Your dietician may help choose foods that are easier to eat, if you suffer from mouth sores or other eating problems after the bone marrow transplant. Do not share certain materials such as, forks, spoons or glasses even with your family members. Additionally;