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The Leukemia/Bone Marrow Transplant Program of BC

Allogeneic Transplant
Post-BMT Phase

Managing Low White Cell Counts

Engraftment   Managing Low Platelet Counts
Managing Low White Cell Counts   Transfusions
Managing Low Red Cell Counts    


In a healthy individual, white blood cells provide protection against infections caused by bacteria, viruses and fungi. There are several different types of white blood cells, but neutrophils are the most common type. Neutrophils fight infection by rapidly increasing in number when an infection occurs. They then surround and destroy the infection. Your “absolute neutrophil count” (ANC) is monitored closely after your treatment to give us an indication of your ability to fight infection and to indicate the beginnings of engraftment.

After receiving your transplant, your white blood cell count will decrease quickly and will remain low until the new cells begin to grow (engraftment). During this time, you are at great risk for developing an infection since you will not have white blood cells to fight bacteria, viruses or fungi. Although the risk of infection decreases as the immune system recovers (white blood cell count rises), BMT patients must continue to take protective measures until their bone marrow has fully recovered. Recovery on average takes 6-12 months after the transplant.

Precautions Against Infections

Many precautions are taken to prevent infection in bone marrow transplant patients. For example, the protective isolation procedures and guidelines for visitors are for the purpose of preventing infection while you are in hospital. For a complete guideline on how to prevent infections, go to Patient Education > Your Responsibilities.

Signs of Infection & Management

One of the most common signs of infection is a fever. Most BMT patients will have an increase in temperature that may signal an infection at some point during their transplant experience. Infections can occur at any time prior to, during, and after the transplant. Because all people carry germs (organisms) in their systems naturally, infections in the transplant patient are often from the patient’s own organisms. Although infections can be quite serious, there are many approaches to treatment. Anti-bacterial, anti-viral and sometimes anti-fungal medications are prescribed during the Post-BMT Phase to treat these different types of infection.

To help identify an early infection, it is important to let the health care team know how you are feeling. Some symptoms of an infection are:

  • Fever of greater or equal to 38°C (Celsius) or 100°F (Fahrenheit)
  • Skin tenderness
  • Chills/sweating
  • A burning feeling when urinating
  • Rectal pain/tenderness
  • A cough, sore throat or mouth pain

If any of these symptoms appear, notify your nurse or doctor IMMEDIATELY.

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