University of Pennsylvania Health System

Focus on Cancer

Monday, December 12, 2011

Life After A Bone Marrow Transplant

Bone marrow transplantation (BMT) treats multiple myeloma, leukemia and lymphoma.

High-dose chemotherapy (and sometimes radiation oncology therapies) can affect the bone marrow. Stem cells in the bone marrow make the cells that carry oxygen through the body, fight infection and help blood clot, A bone marrow transplant replaces the patient’s bone marrow with disease-free bone marrow from a healthy marrow donor. Bone marrow donors are often family members, but may also be unrelated to the patient.

Treatment outcomes for bone marrow transplant have improved over the years. However, there are risks associated with bone marrow transplant. Patients who receive a bone marrow transplant may suffer from a graft-versus-host disease, in which the their immune system attacks the donor marrow cells.   Patient’s immune systems are compromised after such intense chemotherapy and graft-versus-host disease can cause serious complications or even death.

Emotions after a bone marrow transplant

Bone marrow transplants also come with a lot of stress. Full recovery of the immune system may take up to two years, placing a great deal of worry and anxiety on both patients and their families.

While many people might assume the most stressful part of treatment involves the decisions made beforehand and the time spent in hospital, life after a bone marrow transplant presents many challenges.

During the early weeks after leaving the hospital patients still have weakened immune systems and their social contact often needs to be restricted.

Other common complaints include poor sleep, memory problems, poor concentration, lack of appetite, nausea, and less sexual desire. Even after one year, bone marrow transplant recipients often report decreased energy and strength, as well as excessive fatigue.

For many, the hope of a quick return to feeling normal is often transformed into frustration. Bone marrow transplant recipients may also struggle with fears and uncertainly about relapse and their long-term health. As a result, even when physical symptoms improve, anxiety and worry may remain a problem for some time.

This frustration can result in depression as recipients come to terms with new issues in their lives such as increased isolation, loss of control, disruption in their work-life and changes in their role within the family and in relationships.

They may also struggle with guilt over feeling like a burden to others in their post-transplant lives. Prolonged and deepening depression is often a sign that further help is needed and the medical team can often help with the decision to seek help from a therapist and/or start anti-depressant medications.

A good outlook after bone marrow transplantation

The good news is that most bone marrow transplant recipients adjust well to life post-transplant. A key factor in coping is having strong emotional support from loved ones.

Support can include:
  • Listening to feelings and anxiety.
  • Acknowledging together new limitations of strength and energy.
  • Accepting help from others including support groups and professionals.
  • Checking in to see how everyone is doing emotionally.
  • Encouraging each other to talk about feelings.

Bone marrow transplant recipients also tend to fare better if they have realistic expectations about their recovery. It is important to spend time before the transplant with the medical team discussing the recovery process. Knowing that recovery can be slow is often a protection against disappointment and unnecessary fear.

Finally, it is also crucial to have positive goals to work towards and a reason to want to feel better. While life can often be put on hold by a BMT, hope and determination can give shape and direction to a fuller life post transplant.

When to get help

If anxiety and depression is not addressed, it can affect the physical recovery on a bone marrow transplant recipient. It’s important for people experiencing these feelings to reach out to a professional for help. If interested in speaking with a counselor, please notify a member of you medical team.

Learn more about the bone marrow transplant and stem cell transplant program at the Abramson Cancer Center.

Learn more about the stem cell transplant program at the Joan Karnell Cancer Center.

Learn more about managing cancer treatment side effects.

1 comment:

  1. I had a transplant 24 years ago. I was 16 and was lucky enough to have a matching sister too. She was only four years old at the time. I am now running in a marathon to raise money for transplants. I'm blogging about my experience on marathonformarrow.org

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