Acute refractory congestive cardiac failure following allogeneic bone marrow transplantation

A young woman aged 18 years underwent allogeneic bone marrow transplantation for severe acute aplastic anaemia. In the 3 weeks following this procedure the platelet count remained between 10 and 30 X 10 q/l, and from the 21st day after the transplant there was relentless progression of congestive cardiac failure resulting in the patient's death 4 days after its onset. Autopsy showed widespread subendocardial haemorrhage and extensive bleeding between the myocardial fibres resulting in refractory cardiac failure. These findings are compatible with drug-induced cardiotoxicity.