Stem Cell Transplantation Program

After the transplant

Following a successful transplant, your child will require specialized care and precautions as their immune system recovers.

Rebuilding your child's immune system

Your child needs a stem cell transplant because her bone marrow has either been damaged by disease or been suppressed by intensive chemotherapy. Since bone marrow cells produce all forms of blood cells, including infection-fighting white blood cells, your child's immune system will also be impaired.

Once the donor stem cells start working, your child's bone marrow will begin to produce healthy white blood cells. However, it will take time for these new cells to become strong enough to fight off infection. It is important you and your child understand that rebuilding your child's immune system is a process that will take several months.
 

Protecting your child at home

Here at Dana-Farber/Children's Hospital Cancer Center, your child is protected from bacteria, viruses and fungi by special air filtering and infection-control precautions. When your child returns home, we will ask your family to take several precautions to provide as safe a recovery environment as possible.

Some of the steps we will ask you to take include:

• removing houseplants
• adopting stringent hand washing habits
• avoiding certain foods, like raw fish, which may lead to infection

Although we require all transplant patients to observe certain precautions against infection after transplant, some of the post-transplant restrictions vary based on the type of transplant performed. An example of this is the time period we ask a patient to wait before visiting public places and returning to school.

• In general, we ask autologous transplant patients (those who receive a transplant of their own stem cells) to avoid common areas like these, which heighten the risk of infection, for at least six months after transplant.
• In comparison, we generally ask allogeneic transplant patients (those who receive donor stem cells) to wait nine to 12 months.
• It’s important to understand that we cannot predict exactly when it will be safe for your child to visit public places or return to school. Our first priority is protecting your child's health, and we will ask you to keep your child at home for a longer period of time if necessary.

Post-transplant vaccinations

In addition to rebuilding itself naturally over time, your child's immune system will also require vaccinations to help it produce disease-specific antibodies. Some of these vaccinations include:

• diphtheria
• tetanus
• polio

Although your child may have been vaccinated, her new immune system needs to be refreshed through another vaccination. Even if your child received routine immunizations prior to transplant, her new immune system will have no memory of those vaccinations. For this reason, your child must be re-vaccinated after a bone marrow transplant.

We recommend waiting a year after the transplantation before your child receives any vaccinations. However, each child is different, and we will adjust this recommendation if necessary. We also suggest your child receive all vaccinations from the same physician. This makes it easier to track vaccination records for things like school, sport or camp applications.

Your child can be vaccinated by Jimmy Fund Clinic staff members or by her primary care provider. In either case, we’ll provide a helpful list to track your child's post-transplant vaccinations.

Our physicians will explain more about immune system reconstitution during your new patient consultation.