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Possible Long Term Side Effects of Allogeneic Transplant

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(608) 265-1700 (clinic)

The Blood and Bone Marrow Transplant program at University of Wisconsin Hospital and Clinics in Madison, Wisconsin has served adult patients since 1981 and pediatric patients since 1982.

 

Every person's transplant experience is unique. Treatment and recovery depend on diagnosis, age, donor and other health factors. Below is a list of complications that long-term survivors may have.

 

Fatigue

 

Tips for managing fatigue include:

  • Get good rest
  • Keep active
  • Recognize patterns of fatigue
  • Plan ahead
  • Delegate activities
  • Conserve energy when possible
  • Take time to relax
  • Report any increase in fatigue

Cognitive Changes

 

Mental changes may include:

  • Memory lapses
  • Poor concentration
  • Stuttering
  • Difficulty spelling
  • Inability to perform jobs that they had been able to do before
  • Difficulty learning new tasks

Most survivors find ways to adjust to these changes by making lists and leaving notes around the house to remind of things that need to be done.

 

Cataracts

 

Cataracts may begin to develop a year after transplant. Cataracts are most likely to occur in patients who have had total body irradiation or extended use of steroid medicine. If cataracts interfere with your vision, they can be surgically removed.

 

Bone Pain

 

If you have bone pain after transplant, do not ignore it. There are two main causes of bone pain after transplant:

  • Osteoporosis: Older adults, patients with multiple myeloma, and young women who go through early menopause after transplant are at higher risk for osteoporosis. Bones may become weak due to disease, use of steroids, lack of calcium, or premature menopause. Estrogen replacement therapy, dietary calcium supplements, and regular exercise can improve bone density. Your doctor may also recommend a class of drugs called bisphosphonates that can help to stabilize bones and slow down osteoporosis.
  • Avascular Necrosis: This condition may be seen in younger patients who have received a lot of steroid medicines. Pain may be present in the hips, knees, or shoulders. Often patients say that the pain is worse when sitting, lying down, or being still for an extended period of time. The pain is improved when walking. In severe cases, the patient may need to see a surgeon to discuss hip, knee, or shoulder replacement.

Thyroid Problems

 

Some transplant survivors who have had total body irradiation (TBI) can develop an under-active thyroid condition called hypothyroidism. Symptoms of hypothyroidism include fatigue, weight gain, and depression. Thyroid problems can be treated with medicine.

 

Numbness and Tingling

 

Numbness and tingling in the hands and feet is a side-effect that some patients have after chemotherapy. This is called peripheral neuropathy. Some types of chemotherapy can damage nerves and cause changes in sensation.

Some patients find that the numbness and tingling get better over time, but it may never go away completely. Talk to your doctor if your symptoms become painful or keep you from doing your daily routine.

 

Increased Risk for Other Cancers

 

Chemotherapy and radiation therapy increase a person's risk for having another kind of cancer later in life. People who have had total body irradiation or GVHD are at an even higher risk. Common tumors include head and neck cancer, skin cancer, and tumors in the liver, brain, thyroid, bone, and connective tissue.

 

Chronic Graft Versus Host Disease (GHVD)

 

Chronic graft versus host disease (GHVD) can occur after allogeneic transplant. It is viewed as a condition that arises after day 100 post-transplant from acute GHVD, but it can appear in patients that have not had acute GVHD, as well. Chronic GVHD can have can have many different symptoms, but most often cGVHD includes skin discoloration, skin thickening and/or skin lesions. Other symptoms of chronic GVHD include severe dry eyes and sensitivity to light, obstructive lung disease, joint contractures, nerve pain, muscle cramps or weakness, difficult or painful swallowing and weight loss.

 

If you develop chronic GVHD, your transplant doctor will try medications and other treatments to relieve symptoms. Often, the symptoms of chronic GVHD will lessen and become more manageable with time.