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The Complete Patient’s Guide to Autologous Stem Cell Transplant (ASCT)

Post-Transplant Diet: Eating Safely During Recovery

Last updated on: 3/24/2025

After an autologous stem cell transplant (ASCT), your immune system remains weak for months, increasing your risk of infections. Following a low-microbial diet can help prevent foodborne illnesses.

“I went through tandem ASCTs in 2019-2020. Before the transplants, I learned about the low-microbial diet and gradually changed my shopping, cooking, and food handling habits. I still follow many of the guidelines today.” – S. Turker

Always consult your doctor or nutritionist about your specific dietary needs and how long to follow these precautions. Generally, these guidelines apply for at least three months post-transplant.

Essential Food Safety Tips

  • Eat freshly prepared meals or frozen foods made at home.
  • Avoid buffets, self-serve food stations, and bulk bins.
  • Choose fresh fruits and vegetables without bruises or cuts. Wash and peel them before eating.
  • Store food safely: Refrigerate leftovers within one hour and consume them within 24 hours. Store eggs and milk inside the fridge, not in the door.
  • Cook foods thoroughly: Meat, poultry, fish, seafood, and eggs should be fully cooked. Steam vegetables when possible.
  • Avoid raw or undercooked foods, including sushi, raw eggs (in dressings or desserts), and unpasteurized dairy.
  • Skip deli meats, unless they’re pre-packaged and heated before eating.
  • Stick to home-cooked meals: Avoid restaurant food, takeout, or meals prepared by others.
  • Practice hand and surface hygiene: Wash hands frequently, clean cutting boards and utensils with hot soapy water, and use antibacterial sprays for surfaces.

What to Eat and What to Avoid

Food Group Lower Risk (Safe to Eat) Higher Risk (Avoid)
Dairy Pasteurized milk, yogurt, cheese Unpasteurized dairy, mold-ripened cheeses (e.g., blue cheese, Gorgonzola)
Eggs Fully cooked eggs, pasteurized egg products Raw or undercooked eggs, foods containing raw eggs (e.g., Caesar dressing, homemade mayo)
Meat & Seafood Well-cooked meats, poultry, canned meats, shelf-stable smoked seafood Raw or undercooked meats, fresh deli meats (unless microwaved), raw seafood (sushi, sashimi, oysters)
Fruits Washed and peeled raw fruits, cooked or canned fruits Unwashed raw fruit, fresh berries, and pre-cut fruits from the store
Vegetables Cooked vegetables, well-washed and peeled raw veggies Unwashed raw vegetables, pre-cut vegetables, raw sprouts (alfalfa, bean sprouts)
Drinks Bottled or boiled water, pasteurized juices, fresh hot coffee or tea Unpasteurized juices, kombucha, fountain drinks, cold-brewed tea, or coffee
Nuts & Seeds Roasted, factory-packaged nuts Raw nuts, nuts in shells
Condiments Individually packaged condiments, pasteurized honey Raw/unpasteurized honey, salad dressings with raw eggs
Bread & Grains Commercially prepared bread, pasta, and cereals Moldy bread, raw grains (e.g., raw oats)
Desserts Store-bought baked goods, packaged ice cream Homemade or unpasteurized ice cream, unrefrigerated cream pastries
Soups All cooked soups, including miso soup None

Additional Guidelines

  • Avoid alcohol until your oncologist clears you.
  • Do not smoke or use tobacco, as it increases infection risk and slows healing.
  • Stay hydrated: Drink at least 2–3 liters of fluids daily.

Following these guidelines will help protect your health while your immune system recovers after ASCT. Always check with your doctor or dietitian if you're unsure about specific foods.

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