Education And Debate

Fortnightly Review: Bone marrow transplantation

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6971.31 (Published 07 January 1995) Cite this as: BMJ 1995;310:31
  1. Richard L Soutar, senior registrara,
  2. Derek J King, consultanta
  1. a Department of Haematology, Aberdeen Royal Hospitals NHS Trust, Foresterhill, Aberdeen AB9 2ZD
  1. Correspondence to: Dr Soutar.

    Abstract

    Summary points

    • Bone marrow transplantation is becoming an increasingly used medical intervention

    • Allogeneic bone marrow transplantation remains a risky medicalprocedure, with mortality about 30%, primarily from graft versus hostdisease and infection; autologous trans- plantation has a more acceptable mortality risk of 5–10%

    • If results of ongoing trials in solid tumours are favourable autologous bone marrow trans- plantation may become a very common form of medical treatment

    • Stem cells collected from peripheral blood are increasingly being used in place of conventional autologous transplantation; they lead to more rapid engraftment, reduce duration of hospitalisation, and may help to control costs

    • As patient numbers increase, general practi- tioners will increasingly be confronted with the long term complications of bone marrow trans- plantation, such as infertility, secondary neo- plasms, and endocrine dysfunction

    • Although most survivors of bone marrow transplantation do well after transplant, 25–50% of patients will have sexual, employment, and psychosocial problems

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