Home > Patients and Families > Life after Transplant > Staying Healthy > Follow-Up Care

Getting Follow-Up Medical Care

When you leave the transplant center after your bone marrow or cord blood transplant (also called a BMT), you will need to see a doctor often for follow-up care. Your follow-up care is an important part of your recovery.

Who you will see

For about the first 100 days after your transplant, you will be treated by your transplant doctors. If you travel to a transplant center far from home, you will need to plan to stay near your transplant center for treatment for the first 100 days and until any transplant complications are resolved. For more information, see Recovery: Days 30-100.

After that time, most likely you will return to the doctor who treated you before your transplant. It will be important for your doctor to stay in close contact with your transplant doctor. You will receive the best care when you and your regular doctor and your transplant doctor work as a team. Communication between all three of you is important. If you live near your transplant center, you may be able to see your transplant doctor for one visit and your regular doctor for the next.

What your doctor will do

Your doctor's visits may include a physical exam, blood counts, kidney and liver function tests and perhaps other tests. The goal of these visits is for the doctor to:

Check how well you are recovering and treat any problems you may be having.
Spot any side effects or complications from your transplant.
Watch for signs that your disease has returned.
Watch for signs of other types of cancer.

How often you will see your doctor

Your transplant center will tell you how often you should see your doctor. At first, you may see your doctor several times a week, then every week and eventually every other week. You may continue to see the doctor often through at least the sixth month after your transplant. Between 100 and 180 days after transplant is when chronic graft-versus-host disease (GVHD) is most likely to begin (though it can also develop later). Many patients are also still taking drugs that weaken the immune system, so the risk for infections remains high. You will need to be in close touch with your doctor during this time so you can be treated quickly if any problems occur.

If you are doing well, your visits will be spaced further apart over time. During the first year, most patients have some setbacks, when they need to see a doctor more often or are admitted to the hospital for a time.

One year after your transplant, you will have a follow-up visit at your transplant center. Most transplant centers schedule annual follow-up visits for several years after your transplant.

Guidelines for long-term care

You will need to be checked for possible side effects of transplant for the rest of your life. Side effects from your transplant can occur many months or even years after transplant. Some can be mild, others can be more serious. Scheduled tests can help detect problems early so that they can be properly treated.

For guidelines to help you and your doctor schedule your long-term follow-up care after transplant, see A Guide to Protecting Your Health after Transplant: Recommended Tests and Procedures. Download the guide from the NMDP’s research partner, the Center for International Blood and Marrow Transplant Research, at www.cibmtr.org/posttransplant or order a printed guide.

The guide includes:

Information about side effects that may occur months or years after transplant
Charts with recommended tests and procedures for your six-month, twelve-month and yearly post-transplant check-ups
Space to record important information about your own post-transplant care
Information to share with your doctors about the tests and procedures you will need after transplant

Symptoms to report to your doctor

It is important to tell your doctor about any unusual symptoms or problems with your health. For the first year after transplant, and sometimes longer, your immune system cannot fight infections well. If you have any signs of an infection, tell your doctor right away. Do not wait for a regular appointment.

Some signs you could have an infection include:

Fever (a temperature over 101° Fahrenheit or 38.0° Celsius, or as directed by your doctor)
Chills
Changes in the skin around your central line, such as redness, swelling or pain
A cough or difficulty breathing
Blood in your urine
Severe diarrhea or vomiting

You will also need to tell your doctor about any symptoms that could be signs of chronic graft-versus-host disease (GVHD). GVHD and other complications of a transplant can occur a long time after the transplant and may be hard to diagnose. If your doctor has not treated many transplant survivors, he or she should discuss your symptoms with your transplant doctor.

Resources for your doctor

Your follow-up care requires specialized knowledge. Your doctor should consult with your transplant doctor about any questions. The National Marrow Donor Program also offers resources for doctors. You can share information on Patient Care Post-Transplant with your doctor, or tell your doctor about the Physician Resources section of this Web site.