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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 - discharge

Your 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 of 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.

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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 the provider to tell you what signs of GVHD you should watch for.

Preventing Infections

Take care to lessen the risk of your child getting infections as suggested by your health care team.

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

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, call your child's health care team. A symptom can be a warning sign of an infection. Watch for these symptoms:

References

Huppler AR. Infectious complications of hematopoietic stem cell transplantation. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 164.

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. Childhood Hematopoietic Cell Transplantation (PDQ®) - Health Professional Version. www.cancer.gov/types/childhood-cancers/child-hct-hp-pdq. Updated June 8, 2020. Accessed October 8, 2020.

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Review Date: 7/21/2020  

Reviewed By: Adam S. Levy, MD, Division of Pediatric Hematology/Oncology, The Children's Hospital at Montefiore, Bronx, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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