What are the side effects of stem-cell transplant? 

A stem-cell transplant for neuroblastoma follows high-dose chemotherapy, which is given to destroy as many cancer cells as possible. While the stem cells help the body recover, this stage of treatment can still cause side effects. 

Not all children experience the same side effects. Many are temporary and improve as the bone marrow and immune system recover. Your child’s healthcare team will monitor them closely and provide supportive care throughout. 

Short-term side effects 

Short-term side effects usually occur during the hospital stay for transplant and in the weeks afterwards. These may include: 

• Very low blood counts, which can lead to:  

A higher risk of infection 

Anaemia (low red blood cells), causing tiredness or breathlessness 

Easy bruising or bleeding due to low platelets 

• Tiredness and feeling unwell: children often feel very tired and generally unwell during and after treatment. Rest and gentle activities can help. 

• Sore mouth and throat (mucositis): ulcers and soreness can affect the digestive tract, causing discomfort and problems with eating. Nutritional support may be needed. 

• Nausea and vomiting or diarrhoea: these are common but can usually be managed with medicines. 

• Hair loss, if this has not already occurred: this is usually temporary. 

• Loss of appetite or difficulty eating: some children may need additional nutritional support, such as a nasogastric (NG) tube, if they are unable to eat enough. 

During this period, children are usually cared for in isolation to reduce the risk of infection. 

Possible longer-term side effects 

Most children recover well after a stem-cell transplant, and not all children experience longer-term side effects. 

When longer-term effects do occur, they usually develop months or years after treatment and vary from child to child. The likelihood depends on factors such as your child’s age, the chemotherapy drugs used, and whether they have more than one transplant. 

Possible longer-term effects can include: 

• Effects on growth and development 

• Hearing problems 

• Effects on organs such as the heart, lungs, kidneys or liver 

• Fertility problems later in life 

Your child will have long-term follow-up care so that any late effects can be identified and managed early. Your clinical team will explain what monitoring is needed and support your child as they grow and develop. 

Monitoring and support 

Stem-cell transplant is an intensive stage of treatment, and families are closely supported throughout. Your child’s healthcare team will explain what to expect, manage side effects, and monitor recovery carefully during hospital admission and after discharge. 

If you have concerns at any stage, you should contact your child’s treatment team for advice and support.