The major risk of both treatments is an increased susceptibility to
infection and bleeding as a result of the high-dose cancer treatment.
Doctors may give the patient antibiotics to prevent or treat infection. They may also give the patient transfusions of platelets to prevent bleeding and red blood cells to treat anemia.
Patients who undergo BMT and PBSCT may experience short-term side
effects such as nausea, vomiting, fatigue, loss of appetite, mouth
sores, hair loss, and skin reactions.
Potential long-term risks include complications of the pretransplant chemotherapy and radiation therapy, such as infertility (the inability to produce children); cataracts (clouding of the lens of the eye, which causes loss of vision); secondary (new) cancers; and damage to the liver, kidneys, lungs, and/or heart.
With
allogeneic transplants, GVHD sometimes develops when white blood cells
from the donor (the graft) identify cells in the patient’s body (the
host) as foreign and attack them. The most commonly damaged organs are
the skin, liver, and intestines. This complication can develop within a
few weeks of the transplant (acute GVHD) or much later (chronic GVHD). To prevent this complication, the patient may receive medications that suppress the immune system. Additionally, the donated stem cells can be treated to remove the white blood cells that cause GVHD in a process called “T-cell depletion.” If GVHD develops, it can be very serious and is treated with steroids or other immunosuppressive
agents. GVHD can be difficult to treat, but some studies suggest that
patients with leukemia who develop GVHD are less likely to have the
cancer come back. Clinical trials are being conducted to find ways to
prevent and treat GVHD.
The likelihood and severity of
complications are specific to the patient’s treatment and should be
discussed with the patient’s doctor.
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