31 NCCN Guidelines for Patients ® : Multiple Myeloma, 2019 3 Myeloma treatments Stem cell transplants After chemotherapy, blood counts can be very low leading to increased risk of infections and bleeding. The high dose of chemotherapy can result in nausea, vomiting, diarrhea, and mouth sores. You will likely feel tired and weak shortly after the transplant while waiting for the new blood stem cells to grow in the bone marrow. This weak and unpleasant feeling might last for several weeks after you go home, too. Allogeneic stem cell transplants have a high risk of GVHD ( g raft- v ersus- h ost d isease). GVHD is when the donated cells see the cells in your body as foreign and attack them. The parts of the body most commonly damaged by GVHD are the skin, intestines, muscles, joints, eyes, and liver. GVHD is a serious side effect that can cause the transplant to fail by stopping the donated blood stem cells from growing in your bone marrow. GVHD can happen within a few weeks after the allogeneic transplant or much later. Your doctor will give you medicine that suppresses your immune system to try to prevent this side effect. You may also receive other drugs as needed to treat GVHD. “ I never feel alone as my oncology team really cares about me. They include my doctor and the entire nursing team. - Robin Helpful tips: ü Keep a list of contact information of all of your health care providers. ü Use a calendar or ask a caregiver to make note of your treatment schedule and follow-up appointments.