Stem Cell Transplant Engraftment
Newly transplanted stem cells usually begin to engraft (or repopulate) the body with healthy cells within 2–4 weeks after a stem cell transplant.
It may take several weeks after engraftment for a child's new bone marrow to produce enough mature cells in the body. The first sign of engraftment is an increase in the white blood cell count.
Until engraftment occurs, patients have a high risk of:
- Infections because of a lack of white blood cells)
- Bleeding because of a lack of platelets)
- Fatigue because of a lower number of red blood cells
Blood tests are done to check the levels of these cells and to determine if transfusions are necessary to keep red blood cells and platelets at a safe level. Lab draws and transfusions are done through the patient's central venous catheter.
What Else Happens After the Transplant?
During the next few days to weeks after the stem cell infusion, but before the cells have matured, the patient's blood counts are very low due to the chemotherapy and/or radiation received before the transplant.
To speed the recovery of the white blood cells, which in turn helps many of the problems mentioned above, the patient may receive G-CSF (Neupogen).
They may be very sick during this time with:
- nausea and vomiting
- mouth sores
- skin changes
- liver and kidney problems
The child will also likely have fevers and receive IV antibiotics (through their central venous catheter) to fight infections.
The medical team will monitor the child and any complications that occur very closely during this time.