Nursing care issues in autologous bone marrow transplantation

The significant growth in annual numbers of autologous bone marrow transplant (ABMT) procedures can be attributed to early promising results and improvements in supportive care. Expert nursing care is an important component of the care provided by the multidisciplinary transplant team. Nurses are challenged by the developing and rapidly changing nature of ABMT indications, the complexity of the therapy regimen, and the management of acute and long-term effects and toxicities. Nursing care issues pretransplant include assisting the eligible patient in locating and transferring to an ABMT center, assisting with the informed consent process, exploring insurance and financial coverage, and planning for bone marrow and/or peripheral stem cell harvesting. During the transplant, nurses administer complex therapies, provide symptom management, and encourage and support patients and families through the period of pancytopenia and the accompanying physical and emotional debilitation. Post-ABMT, nurses play a key role in helping patients readjust to their former roles.