Sunday, July 5, 2009

What complications and side effects may occur following BMT?

What complications and side effects may occur following BMT?
Complications may vary, depending on the following:

•type of marrow transplant
•type of disease requiring transplant
•preparative regimen
•age and overall health of the recipient
•variance of tissue matching between donor and recipient
•presence of severe complications
The following are complications that may occur with a bone marrow transplantation. However, each individual may experience symptoms differently. These complications may also occur alone, or in combination:

•infections
Infections are likely in the patient with severe bone marrow suppression. Bacterial infections are the most common. Viral and fungal infections can be life threatening. Any infection can cause an extended hospital stay, prevent or delay engraftment, and/or cause permanent organ damage. Antibiotics, anti-fungal medications, and anti-viral medications are often given to prevent serious infection in the immunosuppressed patient.


•low platelets and low red blood cells
Thrombocytopenia (low platelets) and anemia (low red blood cells), as a result of a non-functioning bone marrow, can be dangerous and even life threatening. Low platelets can cause dangerous bleeding in the lungs, gastrointestinal (GI), and brain.


•pain
Pain related to mouth sores and gastrointestinal (GI) irritation is common. High doses of chemotherapy and radiation can cause severe mucositis (inflammation of the mouth and GI tract).


•fluid overload
Fluid overload is a complication that can lead to pneumonia, liver damage, and high blood pressure. The primary reason for fluid overload is because the kidneys cannot keep up with the large amount of fluid being given in the form of intravenous (IV) medications, nutrition, and blood products. The kidneys may also be damaged from disease, infection, chemotherapy, radiation, or antibiotics.


•respiratory distress
Respiratory status is an important function that may be compromised during transplant. Infection, inflammation of the airway, fluid overload, graft-versus-host disease, and bleeding are all potential life-threatening complications that may occur in the lungs and pulmonary system.


•organ damage
The liver and heart are important organs that may be damaged during the transplantation process. Temporary or permanent damage to the liver and heart may be caused by infection, graft-versus-host disease, high doses of chemotherapy and radiation, or fluid overload.


•graft failure
Graft failure is a potential complication. Graft failure may occur as a result of infection, recurrent disease, or if the stem cell count of the donated marrow was insufficient to cause engraftment.


•graft-versus-host disease
Graft-versus-host disease (GVHD) can be a serious and life-threatening complication of a bone marrow transplant. GVHD occurs when the donor's immune system reacts against the recipient's tissue. The new cells do not recognize the tissues and organs of the recipient's body. The most common sites for GVHD are GI tract, liver, skin, and lungs.
Long-term outlook for a bone marrow transplantation:
Prognosis greatly depends on the following:

•type of marrow transplant
•type and extent of the disease being treated
•disease response to treatment
•genetics
•your age and overall health
•your tolerance of specific medications, procedures, or therapies
•severity of complications

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