The right care after your bone marrow transplant is vital to its success. The dedicated team at UCLA Health’s Blood and Bone Marrow Transplant & Cellular Therapies Program is here to help you understand what to expect after bone marrow transplant.
Whether you spend your recovery time in one of our hospitals or outpatient facilities, your care team is available 24/7. They will do everything they can to help minimize your risk of infection and improve your quality of life during this critical time.
Bone marrow transplant: Counting the days
To help you navigate the transplant process, we number the days before transplant, the transplant day and the recovery days. This method helps you understand and anticipate changes and complications that could occur on certain days.
The preparation days before transplant are counted as minus days. Read more about preparing for bone marrow transplant.
The day before transplant is day -1. The day of your transplant is “day zero.” Your bone marrow transplant recovery starts on day +1.
Engraftment and going home after bone marrow transplant
Every patient’s situation is unique, but you can expect to spend 30 to 60 days in the hospital or at the outpatient clinic for your transplant.
The goal of BMT is for the donated cells to enter your bone marrow and start making new cells. This process is called engraftment. Engraftment typically happens around day +15 or +30.
Depending on your condition, you may leave the hospital after engraftment has occurred. But you will still need to be close to the hospital for one to three months after discharge. During this outpatient period, your doctor will continue to track your recovery and watch for complications.
Bone marrow transplant side effects
Your transplant team will closely monitor your progress to stay on the alert for early signs of complications. Side effects can range from mild to dangerous. UCLA Health’s skilled care team aims to minimize these risks for the best possible recovery:
- Risk of infection: Your body is rebuilding an immune system from scratch with the new, transplanted stem cells. During this process (which can take months), you are highly susceptible to infection. Your doctor may prescribe antibiotics or other medications to help prevent infection. You will need to be very careful about interactions with others and avoiding any outside germs until your immune system is functioning again.
- Physical weakness: People often feel very weak after treatment. You might experience extreme fatigue, nausea or vomiting. Be patient — this should pass in a week or so. Remember that your body is busy trying to recover, and give it time to rest and heal.
- Pain: The high doses of chemotherapy used during conditioning may leave you with painful mouth sores and stomach irritation. Talk to your doctor or nurse about your symptoms so we can help you manage them.
- Fluid overload: During your recovery, you will receive a large amount of fluid intravenously (directly into your veins). This fluid helps keep you hydrated and delivers medications, nutrition and blood. But if your kidneys can’t keep up with the fluid coming in, the overload can lead to pneumonia or high blood pressure. We will monitor you for early signs of too much fluid, such as swelling or trouble breathing.
- Respiratory distress: Several side effects of treatment can directly impact your lungs, leading to difficulties breathing. If you have shortness of breath, you may use supplemental oxygen while your lungs continue to recover.
- Graft-versus-host disease (GVHD): The newly transplanted stem cells are replacing your immune system. But sometimes that transplanted immune system can react against your body, attacking your organs. GVHD can range from mild to life-threatening. Your doctors will watch carefully for early signs of GVHD and prescribe medications to control the reaction if it occurs.
In very unusual cases, despite our best efforts, the transplanted cells don’t take hold in the marrow, a problem called graft failure. If graft failure occurs, your doctors will discuss possible next steps and treatments.
Long-term recovery after bone marrow transplant
Our care for you doesn’t stop when you leave our hospital or outpatient clinic. We value your continued recovery and quality of life. Your transplant team will continue to track your condition for years after your bone marrow transplant. Read our patient stories about bone marrow transplant.
To make an appointment with our Adult Blood and Bone Marrow & Cellular Therapies Program, please call 310-206-6909.