Long term effects of stem cell transplantation

There are many possible long term side effects of transplantation. Your child may have none of these problems or may have several.  Members of the SCT team will  monitor your child for any of these side effects.  Most problems can be controlled by medicine or minor interventions.  Remember, the goal is to cure your child so that he/she will live a normal life.  It is very important that your child have annual check ups with the SCT clinic to evaluate for long term side effects.  Many children have few or minor problems after the transplant. 

  • Growth delay. This is most often seen when children receive TBI but can occur after some chemotherapy conditioning regimens also.  If abnormally slow growth is noted, your child will be referred to an endocrinologist for an evaluation of the best plan of care regarding your child’s growth.
  • Thyroid problems. This is seen in about 30% of patients who received TBI.   Thyroid blood tests will be checked routinely.  If abnormal, your child will be referred to an Endocrinologist for replacement therapy.
  • Cataracts. This is usually related to TBI and the use of steroids.  They most often form at least five years after the transplant.  Your child should be seen by an ophthalmologist for regular eye exams.
  • Hearing loss. Antibiotics and some chemotherapeutic agents can cause hearing loss.  Notify your doctor or nurse practitioner if you notice any hearing changes in your child.
  • Lung problems. TBI and some chemotherapy can cause scar tissue to form in the lungs.  Pulmonary function tests will be obtained on a routine basis.  The scarring may be minimal, but may predispose your child to smoking-related lung problems. Your child should never smoke tobacco and should avoid those who do smoke.
  • Heart. Many children who undergo SCT have received medicines that might affect the heart.  TBI may add to that effect.  Heart function will be closely monitored on a regular schedule.
  • Liver. TBI and some chemotherapy can cause scar tissue to form in the liver.  This scarring may never cause problems unless the liver is exposed to other toxins such as excessive alcohol and chemicals (i.e., benzene, etc).
  • Fertility. Generally patients who receive TBI cannot have children.  But there are a few reports of successful pregnancy in women who had TBI.  Your child may experience some delay in puberty, and we may recommend evaluation by the endocrinologist or other specialist for possible testosterone or estrogen therapy.
  • Effects on the brain. TBI and some chemotherapy may have an effect on your child's ability to learn.  This occurs more often in the very young child.  Your child's I.Q. may not necessarily change, but your child may need special tutoring to help with schoolwork.  Neuropsychological testing may be performed as needed to evaluate these issues.

Potential consults after stem cell transplantation

Annual studies may reveal health issues that need treatment.  Your child may be referred to any of these services based on his/her annual studies. 

Conclusions

The SCT team hopes the information in this booklet will answer many of your questions regarding your child’s stem cell transplant.  However, there will be questions and concerns that have not been addressed in this booklet.  Please do not hesitate to contact us.  We cannot emphasize enough how important it is to report anything unusual or anything that is worrying you. It is a good idea to keep a list of your questions and discuss them with us during your clinic visits.  If questions cannot wait until a clinic visit, call us at the outpatient clinic or contact the inpatient charge nurse: