Marrow Matters - Bone Marrow Transplant - Aplastic Anemia  
 
 

 

 
 
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Aplastic AnemiaBMT Long Term Effects

A bone marrow transplant is the only answer to Very Severe Aplastic Anemia. A BMT means life. There are however several long term effects that a BMT can cause, all of which are watched for during clinic appointments to treat them early and prevent them from causing other problems.

attend clinic appointments

It is critical for all bone marrow transplant patients to attend all clinic appointments, have all blood draws done that are requested, and take all medications that are prescribed.

Bone Marrow Post-transplant Complications

A bone marrow transplant (more commonly called a BMT amongst those whom have undergone the severe treatment) is a tremendously intensive treatment that can affect many other systems within the body at any point in time. The only way to safeguard against the possible other diseases and illnesses that a BMT can cause is to attend your clinics.

Some of the complications that can arise are listed below. This list is not exhaustive; other issues can arise, but the good thing to remember is that your doctors are on the look-out for them.

Preparative Regime Complications

Prior to a BMT, an intensive prepatory treatment regime is administered. The exact regime will depend on the treatment facility. (Froedtert).

  • Immune System & risk for infection
  • Emotional health
  • Metabolism and how your body metabolizes and uses energy
  • Lungs
  • Gastrointestinal tract, the gut
  • Kidneys
  • Bones
  • Muscles
  • Nervous system
  • Endocrine system and thyroid
  • Reproduction system
  • Eyes
  • Mouth
  • Skin

Transplant Complications

A BMT can cause complications in the future as a result of the transplant. Many of the late complications and risks of contracting other diseases can be greatly reduced by consistently attending all clinic appointments so that they can be quickly identified and treated.

The risks of these types of complications increase with time, so it is imperative to continue clinic appointments for many years (10 plus - long after you are determined to be cured of Aplastic Anemia).

Some of the latent complications include:

  • Quality of life issues often exist due to a suppressed immune system, such as
  • Fatigue lasting for a long time or permanently; exercise that was one restricted to retain as many blood cells as possible is highly recommended after a transplant; exercise also increases stamina and reduces fatigue; if you feel fatigued, you should discuss it with your doctor immediately;
  • Concentration issues sometimes continue post-transplant as a result of the medications used prior to the transplant and other post-transplant issues; if you have issues with concentration, discuss it with your doctor right away;
  • Sexuality issues, including depression from the lack of ability to conceive, pain in women with intercourse, low sex drives; again, discuss this with your doctor at your earliest opportunity.
  • Unfortunately, a BMT patient is also at a higher risk for contracting cancer in the future than the general population regardless of whether the BMT was for cancer; a BMT is at a substantially higher risk for contracting any cancer, and more so for contracting skin cancer, oral cancer and breast cancer; if you smoke, don't, it could cause numerous cancers.

Chronic Graft-Versus-Host Disease

what causes GVHD?

Graft-versus-Host Disease (GVHD) can be caused by blood stem cell transplants from bone marrow or peripheral blood, as well as blood transfusions.

Donors provide the graft; recipients are the host of the transplanted cells. Graft-versus-Host Disease (GVHD) occurs when the transplanted or infused blood cells recognize that they are in the wrong body, and react against the recipient's organs.

Graft-versus-Host Disease (GVHD) only occurs in transplant patients whose BMT was of blood stem cells from other people (allogeneic transplant); people whose BMT was from their own cells (autologous transplant) do not acquire GVHD as their is no graft to cause the disease.

GVHD is common; about 50-75% of all allogeneic transplant recipients get chronic GVHD. The Seattle Cancer Care Alliance is a leader in chronic GVHD treatment.

What are the symptoms of GVHD?

One of the first outward signs of GVHD is a moon-shaped face.

Graft-versus-Host Disease (GVHD) can affect any part of the recipient's body, most commonly begins with the skin, can go into remission and never reoccur, and can produce numerous symptoms.

Types of GVHD

Classifying GVHD is still somewhat controversial, but it seems that most of the medical community has resolved to these classifications:

  1. Acute Graft-versus-Host Disease, which comes on rapidly, usually within the first 100 days post-transplant, and usually first apparent with a moon-shaped face and a lacy rash on the skin that develops into an itchy or burning rash that spreads over the entire body and causes the skin to become thick and leathery. Acute GVHD can also attack internal organs.
  2. Chronic Graft-verus-Host Disease, which develops over time, usually within 3-6 months post-transplant, but which can also develop earlier and at the same time as Acute GVHD.
  3. Chronic & Acute GVHD occurs when both forms exist concurrently. Recent research has indicated that this occurs much more common than previously thought.

One is not necessary a predecessor to the other form of GVHD. People whom have never had Acute GVHD develop Chronic GVHD; however, people whom have had Acute GVHD are far more likely to develop Chronic GVHD.

See more at GVHD.

Cancer Recurrence

Recurrence of cancer can occur post-transplant, even though the patient is considered cured by the transplant if the patient had a cancer initially.

Recovery

Full recovery of a person who does not have GVHD takes at least 12 months. Full recovery of a person who has Chronic GVHD will take much longer. During that time, they may have symptoms of fevers, chills, coughing, shortness of breath or difficulty breathing, severe diarrhea or vomiting. All symptoms should be immediately reported to your doctor.

Recovery is also a slow process. It is vitally important to continue a regime of plenty of rest, at least some exercise on a daily basis, and very good nutrition. The lack of any one of these components may drastically increase your recovery time, and may cause additional complications in the meantime.

Starting your new post-transplant life

Be very proud of the journey you have taken, for it is a journey that few have the privilege to undergo. "Privilege?," you might ask. Yes, privilege. You have been through and survived a tremendously intensive treatment.

Be patient with your body; it's undergone a tremendous ordeal, and was physically reborn. It needs time to mature and develop (to heal and sustain).