Even if you’re feeling well, your checkups are important to staying healthy because late complications can happen. Late complications are health problems that can start 100 or more days after transplant. During your checkups, your doctor will:
- Look for signs and symptoms of problems from your treatment, like graft-versus-host disease (GVHD) if you had an allogeneic transplant
- Talk with you about what cancer screenings you may need
- Watch for signs of the disease coming back (relapse)
- Ask about your quality of life, including your emotional and sexual health
How are late complications treated?
If you have late complications after transplant, there are treatments available. When problems are found early, they can be treated better. Sometimes, you may need to try 2 or 3 different treatments before finding a medicine or combination of medicines that work best for you. Talk to your doctor to learn more about the best treatment for you.
Be The Match® offers free after transplant care guides that you can share with your doctor. The guidelines give information on the recommended tests and exams for your checkups at 6 months and each year after transplant. The guidelines are available in a free mobile app, online or print. There’s a version for your health care team, too. Bring a copy of your care guide with you to your next BMT appointment.
Here are some tips to manage symptoms of common late complications:
- Dryness, itching, irritation: Avoid eye strain and rest your eyes. Use preservative-free artificial tears, a humidifier or warm compresses. For more difficult symptoms, ask your doctor about medicines for your eyes or “punctal plugs,” which help your tears last longer.
- Severely dry eyes: Ask your doctor about specially made serum eye drops or bandage contact lenses if other treatments haven’t helped.
- Cataracts: For early or mild cataracts, try new glasses or better lighting. If your sight gets much worse, ask your doctor about cataract surgery.
Heart and blood vessels
- High cholesterol or high blood pressure: Eat a well-balanced diet with less fat and follow an exercise program. Take any medicines as prescribed by your doctor.
- Pain and dryness: Avoid eating very spicy and acidic foods. Ask your doctor about special rinses and lubricants, which may relieve mouth sores.
Skin, bones and joints
- Rashes: When going out into the sun, wear hats and long sleeves to protect your skin. Check with your doctor before using any new skin creams or lotions.
- Scleroderma (hard, tight skin): Scleroderma affects the skin and joints, making them less flexible. Medicines, exercise and physical therapy may help increase blood flow, strength and flexibility.
- Avascular necrosis (also known as osteonecrosis): With avascular necrosis, a bone in a joint doesn’t have enough blood flow. This causes the bone to break down and you may feel joint pain. Your doctors may treat this with medicine, crutches or braces, and range of motion or stretching exercises. In more severe cases, surgery can repair or replace the joint.
- Osteopenia: Ask your doctor if you should be taking calcium and vitamin D supplements or have a test for weak bones. Weight bearing exercise, such as walking, can build bone strength.
Screening for cancer
A new cancer could be a result of your treatment. During your regular checkups, talk to your doctor about your risk for new cancers. Be an advocate for your health by:
- Following cancer prevention recommendations from the American Institute for Cancer Research
- Asking your doctor if you need cancer screenings (like a mammogram)
When a new cancer is caught early, there may be more treatment options available and those treatments can be more effective.
Which doctor should I call?
You likely still have many doctors involved in your care, from your transplant doctor to your hematologist or oncologist to your primary care doctor. That can sometimes make it hard to know who you should call if you have a concern about your health.
Ask your doctors questions so you know who to call:
- Who will manage which parts of my care?
- How are your roles different?
- How will my transplant center share information with my primary care doctor?
- How will my primary care doctor share information with my transplant center team?
- How will information be shared with me?
“Your primary care doctor will likely take care of your general health, like checking for and treating heart disease or diabetes. Your transplant doctor will handle transplant-specific issues, like GHVD. But if you have a new health concern, call whomever you’re most comfortable with. Primary care doctors will usually talk to your transplant doctor to find out who should take care of your question or concern.”
- Navneet Majhail, M.D., M.S., Blood and Marrow Transplant Program, Cleveland Clinic