[Psychosocial issues in bone marrow transplantation: uncertainty and threat to life]

Bone marrow transplantation is a complex medical procedure in which hematopoietic stem and progenitor cells are infused into a patient following high-dose chemotherapy with or without irradiation. Because the allogeneic transplantation is associated with life-threatening physical morbidity, lengthy convalescence, and special isolation, the potential for significant psychosocial uncertainty and psychological morbidity is high in adult patients. This work provides an overview of the medical procedures used in allogeneic transplantation and a review of psychosocial and behavioral issues relevant to transplantation. The discussion is limited to psychosocial issues pertinent to transplant recipients and donors, even though transplantation raises significant psychological issues for medical staff, families and caregivers of recipients.