Bone marrow transplant in children - discharge
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 - dischargeYour child had a bone marrow transplant. It will take 6 to 12 months or more for your child's blood counts and immune system to fully recover. During this time, the risk for infection, bleeding, and skin problems are higher than before the transplant. Follow instructions from your child's health care provider on how to care for your child at home.
What to Expect at Home
Your child's body is still weak. It may take up to a year for your child to feel like they did before their transplant. Your child will likely get tired very easily and may also have a poor appetite.
If your child received bone marrow from someone else, look for signs of graft-versus-host disease (GVHD). Ask your child's provider to tell you what signs of GVHD you should watch for.
Graft-versus-host disease
Graft-versus-host disease (GVHD) is a potentially life-threatening complication that can occur after certain stem cell or bone marrow transplants....
Read Article Now Book Mark ArticlePreventing Infections
Take care to lessen the risk of your child getting infections as suggested by your health care team.
- Keeping your house clean is important to help prevent infection. But do not vacuum or clean while your child is in the room.
- Keep your child away from crowds.
- Ask visitors who have a cold or other respiratory infection to not visit or if necessary, to wear a mask.
- Do not let your child play in the yard or handle soil until your provider says your child's immune system is ready.
Make sure your child follows guidelines for safe eating and drinking during treatment.
Safe eating
When you have cancer, you need good nutrition to help keep your body strong. To do this, you need to be aware of the foods you eat and how you prepa...
Read Article Now Book Mark ArticleDrinking
During and right after your cancer treatment, your body may not be able to protect itself against infections. Germs can be in water, even when it lo...
Read Article Now Book Mark Article- Do not let your child eat or drink anything that may be undercooked or spoiled at home or when eating out. Learn how to cook and store foods safely.
- Make sure water is safe to drink.
Make sure your child washes their hands thoroughly with soap and water often, including:
Washes their hands thoroughly
Washing your hands often during the day is an important way to help reduce the spread of germs and prevent illness. Learn when you should wash your ...
Read Article Now Book Mark Article- After touching body fluids, such as mucous or blood
- Before handling food
- After going to the bathroom
- After using the telephone
- After being outdoors
Ask your child's provider what vaccines they may need and when to get them. Certain vaccines (live vaccines) should be avoided until your child's immune system is ready to respond appropriately.
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. Tell your child's dentist that your child has had a bone marrow transplant. That way you can work together to ensure the best oral care for your child.
- Have your child brush their teeth and gums 2 to 3 times a day for 2 to 3 minutes each time. Use a toothbrush with soft bristles. Floss gently once a day.
- Air dry the toothbrush between brushings.
- Use toothpaste with fluoride.
- Your child's provider may prescribe a mouth rinse. Make sure it is alcohol free.
- Take care of your child's lips with products made with lanolin. Tell your child's provider if they develop new mouth sores or pain.
Take care of your child's braces, retainers, or other dental products:
- Children can continue to wear oral appliances like retainers as long as they fit well.
- Clean retainers and retainer cases daily with an antibacterial solution. Ask your provider or dentist to recommend one.
- If parts of braces irritate your child's gums, use mouth guards or dental wax to protect the delicate mouth tissue.
General Care
If your child has a central venous line or PICC line, be sure to learn how to keep it clean to avoid infections.
Central venous line
You have a central venous catheter. This is a tube that goes into a vein in your chest or neck and ends at your heart. It helps carry nutrients or ...
Read Article Now Book Mark ArticlePICC line
A peripherally inserted central catheter (PICC) is a long, thin tube that goes into your body through a vein in your upper arm. The end of this cath...
Read Article Now Book Mark Article- If your child's provider tells you your child's platelet count is low, learn how to prevent bleeding during treatment.
Prevent bleeding during treatment
Your bone marrow makes cells called platelets. These cells keep you from bleeding too much by helping your blood clot. Chemotherapy, radiation, and...
Read Article Now Book Mark Article - Ask your child's provider about liquid food supplements that can help them get enough calories and nutrients.
- Protect your child from the sun. Make sure they wear a hat with a wide brim and sunscreen with an SPF of 30 or higher on any exposed skin.
Take care when your child plays with toys:
- Make sure that your child only plays with toys that can easily be cleaned. Avoid toys that cannot be washed.
- Wash dishwasher-safe toys in the dishwasher. Clean other toys in hot, soapy water.
- Do not allow your child to play with toys that other children have put in their mouth.
- Avoid using bath toys that retain water, like squirt guns or squeezable toys that can draw water inside.
Be careful with pets and animals:
- If you have a cat, keep it inside. Do not bring in any new pets.
- Do not let your child play with unknown animals. Scratches and bites can easily get infected.
- Do not let your child come near your cat's litter box.
- Talk to your provider if you have a pet and learn what your provider thinks is safe for your child.
Resuming schoolwork and returning to school:
- Most children will need to do schoolwork at home during recovery. Talk with their teacher about how your child can keep up with schoolwork and stay connected with classmates.
- Your child may be able to receive special help through the Individuals with Disabilities Education Act (IDEA). Talk with the hospital social worker to find out more.
- Once your child is ready to return to school, meet with teachers, nurses and other school staff to help them understand your child's medical condition. Arrange any special help or care as needed.
- Check with your child’s provider about timing of immunizations including COVID-19.
COVID-19
Coronavirus disease 2019 (COVID-19) is a respiratory illness that causes fever, coughing, and shortness of breath, but many other symptoms can occur....
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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 several times per week. Be sure to keep all appointments.
When to Call the Doctor
If your child tells you about any bad feelings or symptoms, contact your child's health care team. A symptom can be a warning sign of an infection. Watch for these symptoms:
- Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
Read Article Now Book Mark Article - Diarrhea that does not go away or is bloody
- Severe nausea, vomiting, or loss of appetite
- Inability to eat or drink
- Weakness
- Redness, swelling, or draining from any place where an IV line had been inserted
- Pain in the abdomen
- Chills, or sweats, which may be signs of an infection
- A new skin rash or blisters
- Jaundice (skin or the white part of the eyes looks yellow)
Jaundice
Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Jau...
Read Article Now Book Mark Article - A very bad headache or a headache that does not go away
- A cough
- Trouble breathing when at rest or when doing simple tasks
- Burning when urinating
References
Huppler AR. Infectious complications of hematopoietic stem cell transplantation. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 180.
Im A, Pavletic SZ. Hematopoietic stem cell transplantation. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 28.
National Cancer Institute website. Pediatric hematopoietic stem cell transplant and cellular therapy for cancer (PDQ®) - Health Professional Version. www.cancer.gov/types/childhood-cancers/hp-stem-cell-transplant. Updated June 13, 2024. Accessed August 21, 2024.
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Review Date: 8/12/2024
Reviewed By: Rachel Offenbacher, MD, Pediatric Hematology & Oncology, The Children's Hospital at Montefiore, Bronx, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.