During your child’s blood and marrow transplant (BMT) they take many chemotherapy medicines. These drugs are important because they kill your child’s diseased marrow cells.
The treatment is an effective way to prepare your child’s body for the transplant. But some of these medicines may also damage healthy cells in different parts of the body. This can appear as side effects many years after your child finishes treatment. These are called late effects.
Many of the potential late effects are a consequence of certain kinds of chemotherapy.
During your child’s blood and marrow transplant (BMT) they take many chemotherapy medicines. These drugs are important because they kill your child’s diseased marrow cells.
The treatment is an effective way to prepare your child’s body for the transplant. But some of these medicines may also damage healthy cells in different parts of the body. This can appear as side effects many years after your child finishes treatment. These are called late effects.
Many of the potential late effects are a consequence of certain kinds of chemotherapy.
Because children with various illnesses are treated with BMT, your child may experience late effects that are due to their disease treatment. However, there are some complications that may be more related to the transplant itself.
Learning about the possible late effects may be overwhelming. Keep in mind that these are the potential late effects not necessarily effects that your child will develop. Many BMT survivors go on to lead healthy and productive lives. Being aware will help you prepare for these, so that you can look for early signs and get the best treatment right away.
Fertility
When your child enters adulthood, they may start to think about having children. The high-dose chemotherapy that your child receives before the transplant may affect your child’s fertility. Children who received a bone marrow transplant (BMT) may have problems reproducing when older. If your child is diagnosed around the age of puberty (age 11 or 12) or later, you and your child may want to consider banking his sperm.
Discuss these options with your child’s doctor if you or your child has any questions or concerns.
Secondary cancers
Another potential risk after receiving an allogenic transplant is developing secondary cancers.
While preparing for the transplant, your child received chemotherapy. They may have also received previous radiation therapy. These treatments help kill any diseased or cancerous cells. However, these treatments also make children at risk of developing secondary cancers.
Regular follow-up after treatment is important so that your child's doctor can check for any early signs of these cancers.
Heart problems
As part of your child’s conditioning regimen, they may take a chemotherapy medicine called cyclophosphamide. This medicine can be toxic to cells inside the heart. Damage to the heart cells can make it hard for the heart muscle to pump properly. Eventually, the heart just cannot keep up and your child can develop symptoms like fatigue or breathing problems.
Your child takes a low dose of cyclophosphamide to try to minimize the effects on the heart. It is important for your child to see a doctor often and have a heart ultrasound (echocardiogram) regularly.
Dental
Your child may experience problems with their teeth. Dental problems are a side effect from the conditioning regimen. Children who receive a transplant before the age of five are particularly vulnerable to developing issues with their teeth. These problems may include:
- loose teeth
- tooth loss
- dry mouth
- incapable of wearing braces
It is important that a dentist checks your child’s teeth routinely, after the transplant. Some dentists are experienced in treating children who have received high-dose chemotherapy and previous radiation treatment.
Respiratory problems
Some children may experience respiratory problems, such as shortness of breath or cough. This is usually a late effect from conditioning therapy. For most children, the effects are minor and they have no problem participating in the same activities as other children.
Diagnosing respiratory problems early can help minimize the chances of your child developing problems with their lungs. It is important for your child to have their lungs checked every two years. This is done using a test that measures the strengths of the lungs, in a test called pulmonary function test.
Cataracts
As part of previous therapy, your child may have taken steroids for a long time. These medicines may cloud the lens of the eye, interfering with eyesight. This is called cataracts. It can develop gradually over several years.
Like many other potential late effects of treatment, identifying signs of cataracts in the early stages is important for prevention. Your child to see an eye specialist, at least once every two years.