Beth W.

Hi, I had a successful transplant from an unrelated donor 18 months ago.  I’m 67 years old, I’ve always been very physically active, but I can’t seem to shake related health issues such as shortness of breath, weight gain, weak muscles, tachycardia, skin issues.  Will I ever feel normal again?  Will I ever be back to where I was prior to this disease?

Dr. Nandita Khera:

Thank you, Beth, for your question. My name is Nandita Khera, I’m an adult blood and marrow transplant physician at Mayo Clinic Arizona, and I do take care of patients like you.

First, you have to make sure that your doctor has ruled out medical issues such as heart problems as a result of the chemotherapy or the transplant that you have had. This can be done by doing an echocardiogram and other testing. Also make sure that chronic graft versus host disease (cGVHD) affecting lungs has been ruled out by doing lung function tests. And sometimes the graft versus host disease can affect muscles causing muscle weakness.

They should be testing for enzymes like creatine kinase and aldolase. This could be the root cause of the symptoms you are describing. Unfortunately, the transplant even though it’s successful for the disease, meaning it has cured you of that disease, it can sometimes end up with these quality-of-life issues that you are describing.

Interestingly, there are a lot of studies going on in the field right now that are trying to understand the mechanisms behind some of these late effects. Hopefully their results will help us start to develop targeted interventions around these.

For you, I would recommend a positive outlook and exercise regimen, good nutrition, close monitoring, and optimal treatment for the medical complications that you have with your doctor. That would be helpful. Please don’t be too hard on yourself and trying to reach your benchmarks that you had before transplant. You have gone through a lot and hope that the time your body will be able to recover closer to your baseline. Thank you and have a good day.