P atients who have undergone a Stem Cell Transplant will have lowered blood counts for a period of time after their transplant recovery. This period of time varies from patient to patient. Allogeneic transplant patients will take as much as twice as long as Autologous transplant patients to recover full immune function.
During this period of reduced immune function there will be much lower than normal neutrophil counts. Neutrophils are the primary infection fighting white blood cells. Patients must do everything they can to avoid unnecessary exposure to bacteria in order to avoid overwhelming the immune system. This means strict dietary rules to follow.
The Neutropenic diet shown below seeks to reduce the amount of food introduced into the body that has high levels of bacteria. While there are many good bacteria in our food there are also many bad bacteria. Healthy people have immune systems that can easily deal with the bad bacteria, but such is not the case for those with reduce immune function.
Below is a guide to foods that are allowed, and those that you should avoid during this period to reduce your risk of bad bacteria.
Allogeneic patients should follow this for about
4-6 months post transplant
Autologous patients should follow this for
1-3 months post transplant
Click here to download a printable version
FOOD GROUPS
ALLOWED
NOT ALLOWED
Dairy
All pasteurized, grade "A" milk and milk products.
Commercially-packaged cheese and cheese products made with pasteurized milk (i.e. mild and medium cheddar, mozzarella, parmesan, Swiss, etc.)
Pasteurized yogurt
Dry, refrigerated, and frozen pasteurized whipped topping
Ice cream, frozen yogurt, sherbet, ice cream bars, homemade milkshakes
Commercial nutritional supplements and baby formulas, liquid and powdered
Unpasteurized or raw milk, cheese, yogurt, and other milk products
Cheeses from delicatessens
Cheeses containing chili peppers or other uncooked vegetables
Cheese with molds (i.e. blue, Stilton, Roquefort, gorgonzola)
Sharp cheddar, brie, camembert, feta cheese, farmer's cheese
Vegetables
All cooked frozen or canned vegetables.
All cooked herbs and spices (add at least 5 minutes before end of cooking)
Raw vegetables, salads
Caesar Salads with Caesar dressing
Pepper
Garnishes
Uncooked herbs and spices
Fruits and Nuts
Canned and frozen fruit and fruit juices
Thick skinned fruits (oranges, bananas)
Melons cut up and used immediately
Canned or bottled roasted nuts
Nuts in baked products
Commercially packaged peanut butter
Dried fruits
Raw fruit; foods containing raw fruits
Unpasteurized fruit and vegetable juices
Raw nuts
Roasted nuts in the shell
Precut fresh fruits
Bread, Grain, and Cereal Products
All breads, bagels, rolls, pan-cakes, sweet rolls, waffles, French toast
Potato chips, corn chips, tortilla chips, pretzels, popcorn
Cooked pasta, rice, and other grain
All cereals, cooked and ready-to-eat
Raw grain products
Bakery breads, cakes, donuts, muffins
Potato/macaroni salad
Entrees, Soups
All cooked entrees and soups
All miso products (i.e. miso soup)
Meat and Meat Substitutes
All well-cooked or canned meats (beef, pork, lamb, poultry, fish, shellfish, game, ham, bacon, sausage, hot dogs)
Well-cooked eggs (white cooked firm with thickened yolk acceptable, i.e. hard boiled, over hard)
Pasteurized egg substitutes (i.e. Egg Beaters)
Commercially-packaged salami, bologna, and other luncheon meats
Canned and commercially-packaged hard smoked fish, refrigerated after opening
Cooked tofu (which must be cut into 1" cubes or smaller and boiled a minimum of five minutes in water or broth before eating or using in recipes)
Raw or undercooked meat,, poultry, fish, game, tofu
Meats and cold cuts from delicatessen
Hard cured salami in natural wrap
Cold smoked salmon, lox
Pickled fish
Tempe (tempeh) products
Sushi
Raw oysters/clams
Beverages
Tap water
Commercial bottled distilled and natural waters
All canned, bottled, powdered beverages
Instant and brewed coffee, tea; cold brewed tea made with boiling water
Brewed herbal teas using commercially-packaged tea bags
Commercial nutritional supplements, liquid and powdered
Well water (unless tested yearly and found safe)
Cold-brewed tea made with warm or cold water sun tea
Egg nog
Fresh apple cider
Homemade lemonade
Spring water
Fats
Oil, shortening
Refrigerated lard, margarine, butter
Commercial shelf-stable mayonnaise and salad dressings (including cheese-based salad dressings, refrigerated after opening)
Fresh salad dressings containing aged cheese (i.e. blue, Roquefort) or raw eggs, stored in refrigerated case
Desserts
Refrigerated commercial and homemade cakes, pies, pastries, and pudding
Refrigerated cream-filled pastries
Homemade and commercial cookies
Shelf-stable cream-filled cupcakes (i.e. Twinkies, Ding Dong), fruit pies (i.e. Poptarts, Hostess frit pies), and canned pudding
Unrefrigerated cream-filled pastry products (not shelf-stable)
Cream or custard filled donuts
Other
Salt, granulated sugar, brown sugar
Jam, jelly, syrups (refrigerated after opening)
Commercially-packaged (pasteurized) honey
Catsup, mustard, BBQ sauce, soy sauce, other condiments (refrigerated after opening)
Pickles, pickle relish, olives (refrigerated after opening)
Raw or unpasteurized honey
Herbal and non-traditional (health food store) nutritional supplements, Chinese herbs
Brewers yeast, if eaten uncooked
Click here to download a printable version