After your stem cell transplant, it can take a year or more for your immune system to recover, so it’s quite common to pick up infections. If you have graft versus host disease (GvHD) or you’re still taking medication to suppress your immune system, then you may still be at higher risk of infection, even after a year. Infections can sometimes be serious, so it’s important to know what to look out for. You can also download out booklet about dealing with infections.
These types of infections are a common reason for needing to go back into hospital after a stem cell transplant. They include CMV (cytomegalovirus), respiratory viruses (coughs and colds), EBV (Epstein-Barr Virus) and Bk virus.
They all have different signs and symptoms, and you’ll need different treatments depending on what you have. Read our booklet The Seven Steps: The Next Steps for more information.
Read our blog about coughs and colds after a transplant.
Bacterial infections are a common reason for readmission to hospital. One of the most common bacterial infections can come from your central line and they can make you very unwell very quickly. If you have a bacterial infection, you may need medicines such as antibiotics.
Fungal infections tend to occur in the chest or sinuses, but can also be present elsewhere. They often happen when your blood counts are low, but you’ll be taking medication to help prevent them.
In the first three to six months after your stem cell transplant, you should take your temperature regularly, especially if you’re feeling unwell. Your team will give you more detailed advice, but some symptoms to look out for are:
What to do if you see signs of infection
It’s far too easy to put something off until another day. We’ve all had little niggles that we should have had checked out by a doctor or dentist, only for them to be forgotten about in our hectic and busy lives. Unfortunately, if these complications arise, they are unlikely to disappear by themselves and will only get worse if left untreated.
Before you leave hospital, your transplant team will make you aware of symptoms to look for if something starts to go wrong. If you have any of these symptoms, or if you don’t feel like your usual self, it’s time to get checked out. You should have been given the contact details of a doctor or nurse that you can talk to about any problems you are having. You could also visit your GP, but if symptoms develop very quickly, you should go straight to A&E.
Don’t worry about reporting something that turns out to be a false alarm – nobody will be upset with you because of it. It is more important that concerns are raised so that if treatment is needed, it can be given as quickly as possible.
Later on in your recovery
If it’s been many years since your transplant and you’re otherwise well, then normally you can treat simple coughs and colds as anyone else would and see your GP. If in doubt, you can always get back in touch with your transplant team for advice.
A few people continue to have difficulty with their immune system for longer. If you’re getting continuous infections, you may be able to receive immunoglobulin infusions to help boost your immune system. Immunoglobulins are antibodies that help fight infection.
Your team will do tests so they can identify the type of infection and decide on the right treatment. You may not need treatment straight away, and your team might decide just to keep an eye on your symptoms.
If you do need treatment, this could be tablets, treatment through a drip, or through a nebuliser – a device used to give medication in the form of a mist that you inhale into your lungs. You might need to go back into hospital for treatment.
‘I had infections which presented really quickly, and got the right medication in as soon as possible. It was just a hiccup – no one has a completely smooth journey.’
Sarah had a transplant in 2010
For more information about different types of infections read our booklet, The Seven Steps: The Next Steps.
Ask your transplant team if you need to follow this advice for longer than six months.
‘You’ve been through so much; you shouldn’t have to hide yourself away, and not touch your partner or hug your grandchildren. Recovery just takes a long time and you can’t underestimate how heavy a treatment a transplant is – it’s important to have goals of getting back to work and everyday life, but at the same time don’t be too hard on yourself.’
Hayley, Anthony Nolan Lead Nurse
Read Hayley’s blog for more tips on preventing infection after a transplant.
With time you can be more relaxed and your confidence will grow. You don’t have to be as strict with the precautions suggested for the first six months. There are some things you can still do to protect yourself from infections in the long term:
Get immunised: You’ll need to have a number of vaccinations to protect you from infections and illnesses. This includes the vaccinations you had as a child. Read our booklet, The Seven Steps: The Next Steps, for more detailed information.
Look after yourself: There’s no magic potion for boosting your immune system. In general, try and keep fit and well by eating a healthy diet and exercising.
Going back to work: Some people find they’re ready to go back to work about six months to a year after their stem cell transplant. This will vary depending on your recovery and the type of work you do. You’re normally at much less risk of infection at this point anyway, but it’s sensible to take some precautions if you can.
If you have a job where you’re in contact with the general public a lot, see if you can make any changes to your role where you’re less exposed. Find out more about going back to work.
Information published: 10/10/16
Next review due: 10/10/19