【Major points】
  1. The patient's immune system will slowly recover at least half a year after hematopoietic stem cell transplantation.
  2. Fever, diarrhea, skin symptoms or bleeding are common symptoms after hematopoietic stem cell transplantation.
  3. It is still necessary to pay attention to body hygiene and avoid raw food after hematopoietic stem cell transplantation.
  4. It is recommended to rest for half to one year after transplantation before returning to school, employment or traveling abroad.
  5. After the transplantation, please take the medicine on time according to the doctor's instructions, and do not stop the medicine or adjust the dose at will.

I. Why should we pay attention to the home care of patients after hematopoietic stem cell transplantation?

      Hematopoietic stem cell transplantation is a major treatment, especially for patients receiving allogeneic transplantation. The immune system of these patients will slowly recover at least half a year after hematopoietic stem cell transplantation. In addition, "Graft- versus- host- disease" (GVHD for short, means the rejection reaction caused by the donor's lymphocytes attacking the recipient's tissue cells) may occur after allogeneic transplantation, Therefore, although the doctor assesses that the patient's condition is stable and can be discharged, there are still many things to pay attention to.


II. Precautions

      When you return home after hematopoietic stem cell transplantation, you should pay attention to whether you have symptoms such as fever, diarrhea, skin or any bleeding symptoms.


 III. Processing principles

  1. Fever: Because the immune system has not yet recovered, patients are more susceptible to bacterial, viral or fungal infections. If you experience chilliness or fever >38°C, you should return to hospital as soon as possible.
  2. Diarrhea: It may be an infection or a GVHD reaction of allograft. If the diarrhea is severe, you must return to the clinic to ask the doctor for confirmation as soon as possible.
  3. Skin symptoms: For example, if the skin and sclera turn yellow, skin rashes increase, blisters or pain occur, etc., it is necessary to return to the Hematology Oncology Clinic for further confirmation.
  4. Others: If you have oral ulcers, persistent vomiting, tarry stools, or many petechiae on the skin, you need to return to the clinic for treatment.

III Home Care Instructions:

  1. Personal hygiene
    1. Rinse your mouth with salt water or boiled water, brush your teeth after three meals and before going to bed to keep your mouth clean, and check your oral mucosa every day.
    2. Wash your hands frequently, especially before eating, after going to the toilet, or after going home.
    3. Take a bath and change clothes every day, choose cotton clothes to reduce skin irritation, and apply moisturizing lotion to reduce skin dryness or scaling.
    4. Keep the anus and perineum clean and dry after defecation. If there is abnormal redness, swelling, heat and pain around the anus, return to the clinic for evaluation.
  2. Diets
    1. It is best to take high-calorie and high-protein foods, and avoid too hard and irritating foods.
    2. Have frequent small meals, avoid raw food (such as lettuce salad, sashimi).
    3. Eat fresh fruits that can be peeled instead of overnight food.
    4. Be sure to have personal tableware, and the cutting board must be kept dry to prevent mold growth.
  3. Clothing and living environment:
    1. Wash bed sheets, quilt covers, pillowcases, and underwear frequently, and ensure that they are dried.
    2. The house should be ventilated, dry, and sunny. It is recommended to use an air cleaner (please change the filter regularly).
    3. Do not place potted plants, fresh flowers, dried flowers or fake flowers indoors to avoid infection caused by the spread of mold and hyphae in the soil or on flowers and leaves.
    4. Avoid contact with people with colds or infectious diseases.
    5. Do not touch plants, soil, pets' feces directly.
  4. Activities:
    1. You can engage in lower-intensity activities, such as walking. In addition, you should slow down when changing positions to prevent dizziness and falls.
    2. Be sure to wear a mask when going out. If the mask is wet, replace it immediately.
    3. Wear long-sleeved clothes, hats or umbrellas to avoid direct sunlight. 
  5. Recreation:
    1. Avoid taking crowded public transport vehicles, crowded public places or airtight places (such as temples, markets, department stores).
    2.  It takes times to reestablish immune system. It is recommended to rest for half a year to one year before returning to school, employment or traveling abroad.
  6. Others:
    1. If there is Hickmans' catheter or PICC covered with a waterproof dressing, you have to change it every seven days. If it is covered with gauze, it needs to be changed every two days. However, if the gauze or the dressing is wet or contaminated, it should be replaced immediately. If the catheter wound is red, swelling, heat and painful, please return to the clinic for examination. In addition, the catheter must also be flushed with anticoagulant regularly.
    2. Please take the medicine on time according to the doctor's instructions, and do not stop the medicine or adjust the dose arbitrarily. If you are taking cyclosporine, you must refrain from drinking grapefruit juice during the medication.
    3. Sexual needs is normal. It is necessary to pay attention to physical hygiene and use lubricant as needed to avoid possible bleeding or infection.
    4. After being discharged from the hospital, it is still necessary to return to the outpatient clinic of the Department of Hematology and Oncology for follow-up.


  1. Gómez-Almaguer, D., Gómez-De León, A., Colunga-Pedraza, P. R., Cantú-Rodríguez, O. G., Gutierrez-Aguirre, C. H., & Ruíz-Arguelles, G. (2022). Outpatient allogeneic hematopoietic stem-cell transplantation: a review. Therapeutic advances in hematology, 13, 20406207221080739. https://doi.org/10.1177/20406207221080739
  2. Rodrigues, K. S., Oliveira-Ribeiro, C., Gomes, S. D. A. F., & Knobler, R. (2018). Cutaneous graft-versus-host disease: diagnosis and treatment. American Journal of Clinical Dermatology, 19(1), 33-50. https://doi.org/10.1007/s40257-017-0306-9
  3. Wallhult E., Quinn B. (2018). Early and acute complications and the principles of HSCT nursing care. In: Kenyon M., Babic A. (eds) The European Blood and Marrow Transplantation Textbook for Nurses(pp.163-195). Springer, Cham. https://doi.org/10.1007/978-3-319-50026-3_9    
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