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Late effects after allogeneic bone marrow transplantation

H J Kolb1, C Poetscher

  • 1Medical Department III-Klinikum Grosshadern, Ludwig Maximilians Universität, Muenchen, Germany.

Current Opinion in Hematology
|November 14, 1997
PubMed
Summary

Bone marrow transplant survivors face long-term side effects impacting organs and increasing cancer risk. Research is needed to improve prevention and treatment of these late effects for better patient outcomes.

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Area of Science:

  • Oncology
  • Hematology
  • Transplantation Medicine

Background:

  • Late effects are delayed adverse events following bone marrow transplantation (BMT).
  • Increasing survival rates post-BMT highlight the growing importance of managing these long-term complications.
  • Late effects manifest as organ dysfunction, impaired development, or secondary cancers.

Purpose of the Study:

  • To review the spectrum of non-neoplastic and neoplastic late effects after bone marrow transplantation.
  • To identify risk factors associated with the development of these late effects.
  • To emphasize the need for improved strategies for prophylaxis and treatment.

Main Methods:

  • This is a review of late effects based on existing literature.
  • The abstract discusses structural and functional impairments and secondary malignancies.

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  • Risk factors such as intensive therapies and graft-versus-host disease are considered.

    • Main Results:

    • Non-neoplastic effects include impaired growth, endocrine/reproductive issues, and organ-specific dysfunction (eyes, lungs, kidneys).
    • Neoplastic late effects encompass early secondary leukemias/lymphomas and later solid tumors (skin, mucous membranes).
    • Intensive chemotherapy, radiotherapy, chronic graft-versus-host disease, and immunosuppression are identified risk factors.

    Conclusions:

    • Late effects pose significant challenges for long-term survivors of bone marrow transplantation.
    • Incomplete psychosocial rehabilitation remains a concern for a subset of patients.
    • Further research is crucial for enhancing the prevention and treatment of late effects to improve patient quality of life.