More Post-Transplant Precautions - HealthTree for Multiple Myeloma
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chevron_left The Complete Patient’s Guide to Autologous Stem Cell Transplant (ASCT)

More Post-Transplant Precautions

Last updated on: 3/25/2025

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” indiciates “yes”. These are general suggestions based on patient experiences. Please talk to your doctor if you have any specific questions. 

 

Activity

First 6 Months

6 Months to 1 Year

Handling small pets (hamsters, guinea pigs, rabbits, etc.)

N

Y

Reptiles, amphibians (snakes, turtles, lizards, frogs)

N

N

Farm animals (horses, cows, pigs, llamas, etc.)

N

Y

Zoo or petting zoos

N

N

Public aquariums

N

Y

Fishing (wear gloves to handle fish)

Y

Y

Hunting (wear gloves, avoid cleaning game if you have a catheter)

N

Y

Horseback riding

N

Y

Sleeping with, feeding, bathing, or grooming cats/dogs

N

Y

New pets in the home

N

N

Cleaning pet cages, litter boxes, or tanks

N

N

Poultry & wild birds (ducks, pigeons, chickens, etc.)

N

N

Golfing (if no catheter is in place)

N

Y

Attending crowded events (avoid handshakes)

N

Y

Sexual activity

Y

Y

Working on cars (oil changes, engines, etc.)

Y

Y

Camping and hiking

Y

Y

Using a down comforter (with cover)

Y

Y

Returning to school

N

N

Using hot tubs (avoid all public hot tubs)

N

Y

Swimming (if no catheter is in place, avoid submersion & diving, use sunscreen)

N

Y

Gardening, mowing the lawn, or raking leaves

N

N

Having houseplants (not handling them directly)

Y

Y

Baking with yeast (kneading dough by hand)

N

Y

Carpentry work

N

N

Occasional woodworking (sawdust exposure)

N

Y

It can be difficult to live with so many restrictions in 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 to not be able to do things like swimming, woodworking, working on cars, 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 perhaps it is helpful to frame these as precautions instead of restrictions. Everything that exists on this list is a precaution to avoid infection, something that could become determiental to your infant-like immune system. 

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