Anaesthetic implications for bone marrow transplant recipients

Anaesthetic management of bone marrow transplant recipients less than two years of age

“…In allogenic transplants the patient receives marrow from either a relative or unrelated donor, while in autologous transplants the patient's own bone marrow is harvested, saved and frozen for reinfusion later. (Stein, Messino & Hessel 1990).…”

“…The processed marrow is then injected into the central circulation, and marrow stem cells circulate and settle into the patient's bone marrow beds. (Stein, Messino & Hessel 1990).…”

“…Total body irradiation may cause interstitial pneumonitis, pulmonary fibrosis, restrictive cardiomyopathy, oral mucositis, jevere nausea and vomiting and diarrhoea (Pecego et al 1986;Stein, Messino & Hessel 1990). The chemotherapeutic agents adriamycin and daunorubicin can cause severe cardiomyopathy.…”

“…Minimal morbidity and no mortality within 72 h of surgery was reported following the 58 anaesthetics administered to these patients, although four patients died within the first week of overwhelming sepsis. They suggested patients who are undergoing bone marrow transplantation can receive anaesthesia with minimal morbidity or mortality, provided extra care is taken to avoid contamination in these immunocompromized patients (Stein, Messino & Hessel 1990).…”

Anesthesia and graft‐vs‐host disease after hematopoietic stem cell transplantation

“…Chemotherapeutic agents commonly used in the preparative regimen prior to HSCT include cyclophosphamide, busulfan, and fludarabine in combination with TBI. Relevant adverse effects of cyclophosphamide include dilated cardiomyopathy, hemorrhagic cystitis and interstitial pulmonary fibrosis (38). Busulfan causes hepatic VOD and seizures (39).…”