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Differentiating Functional Roles of Gene Expression from Immune and Non-immune Cells in Mouse Colitis by Bone Marrow Transplantation
Published on: October 1, 2012
Long-term effects of bone marrow transplantation
1Fred Hutchinson Cancer Research Center, Children's Hospital and Medical Center, Seattle, Wash.
Insights
Children surviving marrow transplants face delayed effects from the procedure, original disease, and treatment. Awareness of these issues, including graft-versus-host disease and secondary cancers, is crucial for improving long-term quality of life.
Area of Science:
- Pediatric Hematology/Oncology
- Transplantation Medicine
- Long-term Survivorship
Background:
- Increasing numbers of children are surviving longer after marrow transplantation.
- Delayed adverse effects are becoming more apparent in pediatric survivors.
Purpose of the Study:
- To identify and describe the spectrum of late effects following pediatric marrow transplantation.
- To emphasize the need for awareness to improve long-term outcomes.
Main Methods:
- Review of known late effects in pediatric marrow transplant survivors.
- Categorization of effects based on origin: transplant procedure, original disease, or preparative regimen.
Main Results:
- Late effects include engraftment instability, chronic graft-versus-host disease, and delayed immune recovery.
- Recurrent disease is a major concern related to the original illness.
- Therapy-related effects encompass neuroendocrine, ocular, dental, CNS dysfunction, and secondary malignancies.
Conclusions:
- Delayed effects significantly impact pediatric marrow transplant survivors' quality of life.
- Understanding these late complications is essential for proactive management and prevention of growth/developmental abnormalities.
Abstract:
As increasing numbers of children are surviving beyond the 1st decade after marrow transplantation and increasing numbers of children are receiving marrow transplants each year, the delayed effects related to the transplant procedure itself, the original disease, and/or the transplant preparative regimen are becoming apparent. Late effects related to the transplant procedure include those of engraftment stability, the chronic immunosuppression of chronic graft-versus-host disease and delayed immunologic recovery. Recurrent disease is the major late effect related to the patient's original disease. The late effects which may be related to previous therapy administered and/or the transplant preparative regimen include abnormalities of neuroendocrine function, ocular problems, dental developmental abnormalities in young children, central nervous system dysfunction and the development of secondary malignancies. To improve the quality of life of marrow transplant recipients and to prevent some of the growth and development abnormalities which may occur, an awareness of the problems encountered to date is needed.
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