Can You Travel After A Bone Marrow Transplant?

Bone marrow is a soft and spongy tissue in the bones, responsible for producing blood-forming cells in the body. The blood-forming cells are also found in the bloodstream and the umbilical cord blood. These cells are known as blood-forming cells, and turn into blood cells later such as,

• White blood cells (to fight infections)

• Red blood cells (to carry oxygen throughout the body)

• Platelets (clotting of blood)

The bone marrow transplant is preceded by chemotherapy and radiation therapy for the destruction of the damaged blood-forming cells and marrow. Following this, the healthy cells are injected into the bloodstream through an intravenous line. These cells travel through the blood to the bone marrow and start making the healthy RBCs, WBCs, and platelets.  

After how long can one travel after the bone marrow transplant?

Generally, it is safe to travel in most of the conditions. However, people undergoing certain types of treatment that can result in deep vein thrombosis or anything leading to change in the pressure or oxygen concentration in the plane’s cabin. One must consider the following recommendations before deciding to travel abroad after a transplant:

Get advice from your doctor - This is the very first thing, one must consult his/her doctor. Talk to your oncologist and also a doctor who is experienced in travel medicine, to check if you are fit to fly. Depending upon your condition, you may be advised to stay,  choose a developed country instead of a developing one, or fly to a domestic destination where medical provision is easily accessible.

Plan the trip much ahead of time - One must have ample amount of time before traveling. The patients may need to get over any complications or make protective measures such as vaccinations or medical documentation.

Ask about vaccinations - Vaccinations are a significant part of traveling to prevent the most commonly occurring infections in your destination place. The type of vaccines that you require will depend on one of your medical condition, the place you are traveling to, and the recent treatment regime. For example, there are certain vaccines, known as ‘live vaccines’, which might not be recommended to those who already have a weak immune system or those who have recently undergone chemotherapy. The live vaccines in the UK include:

• Measles
• Rubella
• MMR (Measles, mumps, and rubella)
• BCG  (Tuberculosis)
• Yellow fever
• Oral typhoid
• shingles

It is usually safe to interact with people who have had live vaccinations. However, there is a minute risk from those who have taken the live vaccines by mouth. For example, the rotavirus vaccine given to babies. The rotavirus can be transferred within 2 weeks after getting the vaccines. Therefore, one needs to wash hands and avoid changing nappies if possible. Another live vaccine by mouth in the UK is oral typhoid vaccination.

The good news is that inactivated vaccination is a safe option. It contains a killed virus or bacteria. However, these might not function well if you have a weakened immune system. Some of the inactive vaccination given as a mandatory action in most of the bone marrow transplant hospitals in India are:

1. Flu vaccine
2. Hepatitis A and B
3. Cholera
4. Typhoid
5. Tick born encephalitis
6. Japanese encephalitis
7. Tetanus, polio, and diphtheria
8. Rabies
9. Meningitis

Some other measures to prevent infections after the treatment are listed below.

Maintaining hygiene - The most necessary aspect in the prevention of infection is maintaining hygiene. Everyday bath and oral hygiene are important.

Avoid direct contact - Washing hands is highly crucial in the first 6 months after BMT and also while taking immunosuppressive medications. Use antimicrobial soap. The use of a hand sanitizer is also recommended outside the home to avoid stomach infections.

Prevention of infections by respiratory transmission - One needs to avoid works like gardening, mulching, raking, mowing, etc. The soil particles increase exposure to the pathogens that may cause diseases. In addition to this,

• Avoid close contact with people who already suffer from respiratory illnesses such as cough, cold, etc. Avoid going to areas that are overcrowded.
• Avoid visiting construction sites as it can increase exposure to molds.
• Avoid using tobacco and marijuana as increases the risk for bacterial, viral and fungal infections.
• Do not go near wood-burning fireplaces.
• Do not use a room humidifier as it has water-harboring bacteria.

Prevention of infection from water -

Patients who have undergone a bone marrow transplant must stay away from activities such as swimming or playing in recreational water like ponds, hot tubs, etc. You may have an intake of bottled water which has been processed through reverse osmosis, distillation, or one-micrometer particulate absolute filtration.

Some other general tips:

• Never forget to travel with your important documents having details of your medical situation. These might be needed in emergency cases as they will have information about the medications that you would be taking.
• Get a letter from your hospital having a list of medications.
• Eat the food that is hygienically prepared.
• Always keep an insect repellent with you.
• If possible carry your own drinking water with you while traveling.