Marrow Matters - Bone Marrow Transplant - Aplastic Anemia  

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Aplastic AnemiaFood In Post-Transplant Care

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Bone Marrow Transplant
For Aplastic Anemia
Food Care After The Transplant

Common Food Preparation Details

Special care of any food consumed by an Aplastic Anemia post-transplant patient must be observed at all times until the transplant specialist advises otherwise. In any case, food preparation should always follow best care routines.

Post-transplant patients can have a variety of foods so long as they are not on a special diet (such as would be the case for patients affected by GVHD).

sterilize food contact surfaces

All areas where food will be prepared must be sterilized prior to food preparation.

All dishes that will come in contact with the food that a post-transplant patient will consume should be sterilized prior to every use.

Any surface that comes in contact with poultry must be bleached, and any surface that comes in contact with any other meat, fruit or vegetable should be sterilized. Note that bleach is one of few cleaners that destroys poultry bacteria and viruses.

A post-transplant patient cannot consume raw meat, poultry, fish, seafood or any other raw food.


An Aplastic Anemia post-tansplant patient cannot consume food left-over's that are more than 48 hours old. They also should not consume pre-packaged food that has opened when it is over 48 hours; examples include lunchables, cookies and crackers.

buffets, fast food & Deli's

An Aplastic Anemia post-transplant patient cannot eat at at any fast food establishment or consume food from any deli or buffet even if the food is covered for a minimum of 12 months post-transplant, and typically for at least three years.

Meats, Poultry, Fish & Seafood

All meats, poultry, fish and seafood must be cooked 'well done', and cannot have any raw or nearly-raw portions for the post-transplant patient to eat.

Vegetables & Fruits

Aplastic Anemia post-transplant patients have compromised immune systems; consequently, they cannot fight off the typical attack of a fungus or bacteria that a healthy person's system would if consuming something so commonplace as lettuce, raw carrots or the like. Instead, those fugus and bacteria can pose life-threatening risks to the post-transplant patient.

Post-transplant patients cannot peel bananas, cucumbers or oranges. They can eat the fruits when permitted by the transplant team, but someone else must peel the food.

When permissable, lettuce can be consumed by a post-transplant patient so long as the lettuce is washing completely by another person. Later, the post-transplant patient will be able to wear a mask and gloves to clean fruits and vegetables prior to cooking them; at a much later date, they will also be able to consume raw fruits and vegetables, but they should not do so until the transplant team recommends it.

Special Diets

When the Aplastic Anemia post-transplant patient is released from the hospital, he or she may be on a special diet. That diet should be adhered to verbatim; the rsult can be an infection, diarrehea or vomitting.

If the patient develops Graft-Versus-Host Diisease, special diets are almost always prescribed. Those diets may restrict fiber if the GI tract is affected, preclude certain foods such as grapefruit that can render certain drugs ineffective, or require certain foods such as cashews that help a body to retain magnesium.

Sidenote: immunosuppressant drugs, such as Tacrolimus, which is marketed under the Brandname Prograf, destroy magnesium, so magnesium pills are prescribed in large quantity. Cashews and other magnesium-rich foods can help the body to retain magnesium.

Same Food, Different Taste

During the conditioning regime, your post-transplant patient underwent chemotherapy to terminate all fast-producing cells such as hair and taste buds. That chemotherapy, combined with an ongoing hefty regime of ever-changing drugs can cause the patient's tastes to change. As well, the post-transplant patient may tolerate some foods one day, and not be able to tolerate the same food on another day.

Shopping for a post-transplant patient can be an exercise in creativity. A good general rule of thumb is to buy all foods in small quantities, then if desires or tastes change, you aren't left with a cupboard full of something he or she won't eat and you don't like. Of course, this wouldn't be applicable to things like chocolate, which everybody loves (right?). Actually, post-transplant patients may not want or be able to have milk chocolate.

consult your transplant specialist

It cannot be overemphasized: consult with your transplant doctor, listen to your transplant medical team, fly any questions and all life decisions by your medical team, and do not consult with anyone (be it an RN, a doctor, or a nursing student) who is not highly experienced in transplants!


A transplant patient has an entire set of medical needs, medications and regimes that no other person will ever be required to take, let alone become familiar with unless they are a transplant patient or a caregiver.


There are several books on the market written for people who have undergone bone marrow transplants; unfortunately, the majority of those are written for people who had an underlying cancer, such as Leukemia. Even so, the majority of the information is accurate in one of the books that we've read: A Patient's Handbook.

Patient & Caregiver Resource Manual For Adult Allogeneic Patients, Seattle Cancer Care Alliance, Long-Term Follow-Up Program, Dr. Fred Hutchinson.

See also: Engraftment, Post-transplant Household Care