What are the side effects of an autologous stem cell transplant?

The side effects you have will depend on the type of high-dose treatment you had before your stem cell transplant. Most side effects are worst when your blood count is at its lowest. This is usually at the end of the first week and throughout the second week after a stem cell transplant. When your blood count goes up, the side effects will start to improve.

You will have medicines to prevent or reduce side effects. Always tell your doctor or nurse about any side effects you have. They may be able to change the medicines you are taking to ones which will work better for you. Your hospital team will give you more information about what to expect.

Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.

You will be given medicines to prevent and treat infections. Your nurses and doctors will take your temperature regularly and check for signs of infection. They will also ask you to tell them if you have any symptoms that could be a sign of infection. These include:

  • feeling shivery
  • a sore throat
  • a cough or runny nose
  • pain when passing urine
  • diarrhoea.

The hospital staff try to protect you from possible infections. But most people will need antibiotics at some point while their immune system is recovering.

We have more information about infection.

Visitors

You may be restricted to only a few visitors each day. The ward nurses will tell your visitors how to protect you from infections. People should not visit you if they feel unwell or have an infection.

Anaemia

This treatment can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. This is called anaemia. If you are very anaemic, you may need regular blood transfusions until your body starts to make enough red blood cells again.

Irradiated blood

For at least 3 months after your treatment has finished, any blood or platelet transfusions you have are first treated with radiation (irradiated). This is to prevent problems caused by white blood cells called lymphocytes, which are in the donated blood. Irradiated blood is not radioactive and will not harm you or anyone you come into contact with.

Some people may need to have irradiated blood for the rest of their lives. Your doctor can talk to you about this. You will be given a medical alert card to carry in case you need blood in an emergency or at another hospital.

Bruising and bleeding

This treatment reduces the number of platelets in your blood. You are likely to need platelet transfusions to reduce the risk of bleeding or bruising. Any platelets you have will be treated with radiation (irradiated).

Your doctors and nurses will examine you regularly for bruises or little red spots on the skin. Tell a doctor or nurse straight away if you have:

  • any bruising you cannot explain
  • a nosebleed
  • bleeding gums
  • blood in your stools (poo) or urine (pee).

Feeling sick

This treatment can make you feel sick or sometimes be sick. Your doctor will prescribe anti-sickness drugs to prevent or reduce this. Let your doctor or nurse know if your anti-sickness drugs are not helping as there are different types you can try. We have more information about feeling sick.

Sore mouth

The treatment can cause a painful throat and mouth ulcers. While your white blood cell count is low, you are also at risk of mouth infections. Keeping your mouth clean is important to prevent infections that can spread to other parts of your body.

The nurses will advise you how to look after your mouth and teeth. Use a soft toothbrush when cleaning your teeth to protect your gums. You will have mouthwashes to use regularly to try to prevent infections. It is common for your mouth to become sore while your blood count is low. Talk to your doctor or nurse, as they can give you some painkillers. These may be given as liquids or as an injection if you are having difficulty swallowing because of pain.

Eating problems

During treatment, it is important you do not lose too much weight. Try to eat small meals and snacks regularly, even if you do not have much appetite or if food tastes different. Your nurses and dietitian will give you advice.

If you have a sore mouth, eating may be difficult. You may need to have nutritional drinks until you can eat properly again. Sometimes people need to have liquid food through a thin, soft tube that goes down the nose into the stomach (a feeding tube).

Some people may have another type of liquid food that is given through their central line or PICC line. As you start to eat again, the amount of liquid food you are given is gradually reduced.

Diarrhoea

This treatment may cause diarrhoea. Your doctor can prescribe drugs to control it. Let them know if it is severe or if it does not get better. Make sure you drink at least 2 litres (3½ pints) of fluids every day if you have diarrhoea. If you are not able to drink very much because of a sore mouth, you may be given fluids through a drip (infusion). We have more information about diarrhoea.

Hair loss

This is a common side effect of chemotherapy. You usually lose all the hair on your head. Your eyelashes, eyebrows and other body hair may also thin or fall out. It is almost always temporary and your hair will grow back after chemotherapy ends. Your nurse can give you advice about coping with hair loss.

We have more information about hair loss.

Tiredness (fatigue)

You will probably feel extremely tired and spend a lot of time sleeping. Sometimes you may feel too tired to concentrate on reading or watching television.

At times, you may not feel able to have visitors, or see them for too long. Let them know how you are feeling so they do not disturb you if you want to rest.

We have more information about managing fatigue.

Exercise

Even though you are tired, it is a good idea to try to do some gentle exercise, such as stretching. A physiotherapist will show you how. This helps reduce the chances of getting a blood clot. It also helps to keep your muscles working and toned.

Some transplant units may have an exercise bike that you can use when you are feeling better and your blood counts have improved.

Less common side effects of autologous stem cell transplant

Graft failure

Sometimes the infusion of stem cells does not work and the bone marrow does not produce enough new blood cells. This is known as graft failure. It can lead to repeated infections, bruising, bleeding and anaemia. In this situation, growth factors may be used to try to stimulate the bone marrow to recover.

Total graft failure is very rare, and the only way to treat this is with a second infusion of stem cells.

Hepatitis

Any blood or platelet transfusions you are given will be checked for hepatitis B, C and E viruses. This is to reduce the risk of you getting hepatitis from blood transfusions.

Late effects of an autologous stem cell transplant

Some people develop side effects months or years after treatment. These are called late effects. We have more information about late effects of an autologous stem cell transplant.