After an autologous stem cell transplant (ASCT), your immune system remains weakened for 3 to 12 months, increasing the risk of infection. Following these precautions can help protect your health during recovery.

Infection Prevention: Key Guidelines

• Frequent handwashing: Wash hands with soap and warm water for at least 20 seconds, or use an alcohol-based hand sanitizer.
• Wear a mask: Cover your nose and mouth in public places.
• Limit visitors: Avoid contact with sick individuals, those recently ill, or those who have received live vaccines.
• Household precautions: If family members work in crowded environments or travel by plane, they should shower and change clothes before interacting with you.
• Pet safety: No new pets should be introduced. Have someone else handle pet care, keep pets out of your bedroom and bathroom, and wash your hands after touching them.
• Avoid crowded places: Have family or friends run errands or use online delivery services. If you must go out, avoid peak hours.
• Gardening & plants: Avoid gardening, mowing, and raking leaves for at least one year to reduce the risk of fungal infections from soil. Remove indoor plants from frequently used rooms, and do not bring in new plants or flowers.
• Avoid certain water sources: Do not swim in pools, lakes, ponds, or rivers, and avoid hot tubs and saunas while your immune system is rebuilding.
• Stay away from construction sites: Wear a mask near renovations, keep car windows up, and avoid dust exposure.
• Limit sun exposure: Chemotherapy, radiation, and some medications make skin extra sensitive to sunlight. Use SPF 30+ sunscreen, wear long sleeves, pants, and a wide-brimmed hat, and avoid the sun during peak hours.

Common Post-Transplant Restrictions

The following table answers questions about activities post-transplant. “N” indicates “no” and “Y” indicates “yes”. These are general suggestions based on patient experiences. Please talk to your doctor if you have any specific questions.  

It can be difficult to live with so many restrictions at the beginning of your recovery, but there are two very important things to note. One is, for better or for worse, you will not have a lot of energy in the first 100 days post-transplant. This will naturally make it easier not to be able to do things like swimming, woodworking, working on cars, or going camping or hiking. Remember that recovery will come, and you will feel like yourself again; it just might take a while. 

The other thing to note is that framing these as precautions instead of restrictions is helpful. Everything on this list is a precaution to avoid infection, something that could become detrimental to your infant-like immune system. 

This is a temporary time (that will feel like forever!) in which you must be more careful and preventative than normal. It’s frustrating, but the precautions exist for a good reason.