Patients 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.
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 |