Autologous Transplant — Going Home
Most people are more than ready to go home when the time comes. But it is also a time of anxiety. In the hospital there are always people around, checking on the patient several times a day. By contrast, the relative isolation of the home environment can be a little scary. This feeling doesn't usually last long once people have gone home. We always make sure that patients have a list of phone numbers to call if they have questions or don’t feel well. At the Rush Bone Marrow Transplant Center, there is someone on call 24 hours a day. Therefore, someone is available to answer questions or address concerns morning, noon and night.
Patients usually return to the clinic for a follow-up visit a few days after going home. At this visit, clinic staff will review the results of blood tests, ask the patient if he or she has been eating and drinking normally and generally check to make sure there are no problems. The number of times patients need to come to the clinic varies depending on whether they have any problems that need to be watched. A common scenario is for patients to come twice a week for a week or two, then once a week for a couple of weeks, then every two weeks, then monthly until three months after the transplant. At follow-up visits, we also assess whether the central line is still needed. We generally remove the central line two to four weeks after the patient goes home if everything is going well.
A special follow up occurs 100 days (three months) after the transplant. The purpose of this visit is to re-stage the patient and check to see that the disease is under control. We recommend that patients see their oncologists for further follow-up, but return to us yearly so we can check that everything is going well. In particular, we check for late complications of transplantation, such as having low thyroid function.
Getting Back to Normal
After the transplant most people feel tired, especially if they do any activity or try to concentrate. Their stamina improves quite quickly over the first couple of weeks. However, it can take three to six months — and sometimes longer — to feel 100 percent fit. After an autologous transplant, the immune system returns to almost normal quite quickly. People are not at much risk of getting unusual infections but tend to get common coughs and colds more easily, and they take longer to recover from these minor ailments especially in the first year after the transplant. Patients who have had peripheral blood stem cell transplants tend to recover somewhat faster than those who have had bone marrow transplants, because more lymphocytes (a type of white cell) are given with the transplant, which speeds this recovery. Patients will be advised to receive a series of vaccinations starting one year after the bone marrow transplant to boost the immune system so it can be as close to normal as possible. If you have questions about vaccinations, talk to your physician.