Sickness, Vomiting, Diarrhoea and Mucositis: (Painful erosion of mucous membranes of mouth and rest of the gut) As a result of high-dose chemotherapy or radiotherapy. These are usually short-lasting, varying between 3-15 days ranging from mild to severe symptoms. Medicines are there to control these problems.
Infections and Bleeding: (As a result of lack of blood cells in the interim period before the donor stem cells start working). The main risk at this stage is that of bacterial infections, often coming from the stomach to the blood through the damage caused by high-dose chemotherapy. Fungus infections also happen at this stage. This is why we give antibiotics and antifungal against both bacteria and fungus to prevent serious infections.
Acute Graft-Versus-Host Disease: It occurs when the new bone marrow from the donor, called graft, does not recognize the person who receives it, called the host. This leads to reaction of the donor white cells. The graft sends out fighter. The graft then sends out fighter white blood cells, called lymphocytes, to attack the host. It can be mild, moderate or severe and can involve the skin, the liver or the bowel. Rashes and diarrhea are symptoms. Sometimes tissue samples of symptomatic areas are taken to diagnose the disease. This complication is seen with Allogeneic transplants, in which the transplant comes from either a related or unrelated donor. GVHD may settle down in a month or two. Occasionally it last much longer.
Intensive Cart: It may be necessary to be transferred to the ICU. The ICU is the best place if he or she needs special monitoring, mechanical help to breathe or very close medical and nursing attention. The medical and nursing staff will keeps the relatives well informed about whether the patient likely to be transferred to the ICU. The transplant physician will continue to work with the intensive care staff to provide the necessary care.
Late
Virus Infections: (As a result of lack of proper immunity against viruses for the first 3-12 months). The main viruses likely to cause problems are CYTOMEGALOVIRUS (CMV), EPSTEIN BAR VIRUS (EBV), ADENO VIRUS and RESPIRATORY VIRUSES. We check for these viruses routinely for the first three months. CHICKEN PDX VIRUS can also infect very late after transplant and often presents with pain on one side of the chest, belly or face followed by blisters.
Chronic Graft-Versus-Host Disease: (As a result of the lingering reaction of donor white cells against the patient's body). This often manifests with dry and tight skin, joint pains, dry and irritable eyes and mouth ulcers. A bit of this nay be needed to get rid of difficult blood cancers. These symptoms might need prolonged treatment with steroids and other medicines.
