According to Cancer Therapy Advisor, "Infection is a known risk for early death among patients with myeloma." Especially after a bone marrow or stem cell transplant, your immune system is weak and highly prone to infections. While your white blood cell count may be considered "normal", during this time your immune system is recovering and needs to be protected.

Researchers from the American Journal of Hematology studied 613 patients who recently received a transplant. Of the 613 patients, 59 died within 2 years of diagnosis (and 13 within 100 days).

"At the time of death, 83.1% of deceased patients had progressive disease. Infection was the leading cause of death in all deceased patients (44.1%), though an infection was present at the time of death in 59.3% patients, regardless of immediate cause.

Among the 10 patients who died within 2 years of diagnosis without disease progression, half the deaths were due to infection.

Nearly half of the infections were pneumonia."  Cancer Therapy Advisor

TIPS FOR PREVENTING INFECTION

Doctors recommend key steps to prevent infection. Here are a few common tips:

Take care of your hygiene

• Shower/bathe often and take care of your oral health
• Always wash your hands during the first 6 months after your bone marrow transplant (especially before eating, before/after preparing food, after touching animals, after sneezing/coughing or blowing your nose, after going outdoors, before/after infusions, after touching soiled linens or clothes)
• Carry hand sanitizer every time you leave your home

Avoid contact with bacteria-infested areas

• Avoid gardening, mulching, raking, mowing, farming, or direct contact with soil and plants
• Avoid close contact with those who are sick
• Avoid crowded areas in public
• Avoid dusty environments (construction sites, buildings that are being repaired/remodeled, house cleaning that produces dust or mold, etc.)
• Avoid the use of a room humidifier (it gathers bacteria)
• Minimize direct contact with pets/animals
• Avoid walking, wading, swimming, or playing in recreational water (ponds, pools, lakes, hot tubs, etc.)
• If you drink tap water, make sure it's clean (if needed, boil for at least 1 minute before drinking)

It is also recommended that family members and members of your household be vaccinated to minimize exposure to diseases.

EARLY SIGNS OF INFECTION

The sooner an infection is detected the better. If you notice any of the following symptoms, it is recommended you notify the bone marrow transplant team, or your doctor:

• Fever of 100 degrees Fahrenheit, or 100.5 degrees Fahrenheit for autologous patients
• Shortness of breath
• Cough with yellow or green phlegm, or a dry, persistent cough
• Sweats or chills
• Sore throat, scratchy throat, or pain when swallowing
• Sinus drainage, nasal congestion, headaches, or tenderness along the upper cheekbones
• Trouble urinating
• Cloudy or foul-smelling urine
• Redness, selling, tenderness, or drainage at the site of your central venous catheter
• Diarrhea
• Lesions or white patches in your mouth or on your tongue
• Skin rash
• Vaginal discomfort, itching, or usual discharge
• Exposure to chickenpox, strep throat, herpes, or mononucleosis

Overall, we can't protect ourselves from every potential danger, but myeloma patients should be vigilant and take necessary precautions to prevent harmful effects. If an infection is prevented, or caught early on, it could possibly save a patient's life.

Articles referenced: Cancer Therapy Advisor, Cleveland Clinic