Cataract development in adult bone marrow transplant recipients

In a prospective study, adult patients treated with bone marrow transplantation were examined with respect to cataract development. There were 99 patients with a survival of at least one year. Ten of them had aplastic anemia and the rest had various hematological malignancies. Mean follow-up time was 3.9 years (range 1-10). All in the hematological malignancies group but none in the aplastic anemia group, were conditioned with irradiation. Cytostatic drugs were administered in all cases. Depending on the type of disease and its reaction to bone marrow transplantation, steroid treatment was sometimes indicated. Cataract did not occur in any of the 10 patients treated for aplastic anemia, whereas all patients with hematological malignancies had developed cataract after 4 years' observation. Most patients in the hematological malignancies group already showed lens opacifications after 2 years. Cataract surgery on the first eye was performed in 39 cases, a median of 3.7 years after bone marrow transplantation. Cataract development was clearly correlated to radiation. No relationship was found to other conditioning treatments, although a synergistic effect is possible.