Unrelated Donor Bone Marrow Transplantation in Adults: Some Current Controversies

Marks, David I.; Otton, Sophie; Williamson, Emma; Bird, Jennifer M.

doi:10.3109/10428199909058403

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…Matched, unrelated donor‐BMT recipients appear to be more prone to serious infections. The reasons for this are complex and relate to the GVHD prophylaxis used, the higher incidence of GVHD and its therapy, and delayed immune reconstitution (12, 13). Moreover, matched, unrelated donors are not routinely screened for their toxoplasma serologic status, which may bring up the possibility of transplant‐related transmission (1, 14), especially in an endemic area.…”

Section: Discussionmentioning

confidence: 99%

Disseminated toxoplasmosis after bone marrow transplantation: report of 9 cases

Medeiros

Werner

et al. 2001

Transplant Infectious Dis

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Toxoplasma infection following bone marrow transplantation (BMT) is infrequently reported. We report 9 cases of disseminated Toxoplasma gondii infection in BMT recipients documented during an 11-year period at our institution. The incidence of T. gondii infection in our institution (1.14 per 100 allogeneic BMT) is higher than previously reported. The most frequently affected sites were the brain, lungs, and heart. Findings common to most patients who developed toxoplasmosis were positive pre-transplant serology, allogeneic transplant and graft-versus-host disease and its treatment, as well as BMT from matched unrelated donors. All 9 patients died and 8 were diagnosed only after autopsy. Heightened awareness of the occurrence of toxoplasmosis in marrow recipients, especially in highly endemic areas, and early diagnosis and therapy are needed for a better outcome.

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Section: Discussionmentioning

confidence: 99%

Disseminated toxoplasmosis after bone marrow transplantation: report of 9 cases

Medeiros

Werner

et al. 2001

Transplant Infectious Dis

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“…Possible mechanisms are mucosal damage caused by viral cytopathic effect or cytokine release, and immune disregulation (13). Potentially life‐threatening infections occur in more than half of the patients undergoing UD‐BMT (7, 14).…”

Section: Discussionmentioning

confidence: 99%

Cavernous sinus thrombosis caused by zygomycosis after unrelated bone marrow transplantation

Medeiros

Bleggi-Torres

Faoro

et al. 2001

Transplant Infectious Disease

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Invasive zygomycosis is a devastating fungal infection occurring as an opportunistic infection after bone marrow transplantation (BMT). Sinusitis can lead to fungal infection in immunosuppressed patients, and cavernous sinus thrombosis, an uncommon condition in immunocompetent patients, typically follows an infection involving the medial third of the face, nose, or paranasal sinuses. Patients undergoing unrelated-donor BMT (UD-BMT) are prone to develop life-threatening infections because of poor recovery of cellular immunity. Despite adequate clinical evaluation and treatment, the prognosis of patients with invasive fungal infections is dismal, especially when intracerebral structures are affected. We describe a case of a patient who underwent an UD-BMT and developed cavernous sinus thrombosis after sinusitis due to zygomycosis. Moreover, he also had disseminated fungal (Zygomycetes and Aspergillus) and viral (cytomegalovirus and adenovirus) infections.

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“…Unrelated donor bone marrow transplantation (UD-BMT) is being used with increasing frequency as curative therapy for a variety of haematological malignancies and nonhaematological conditions 1 and results are improving. 2 Some recent survival figures reported approach those seen with sibling allografts.…”

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confidence: 99%

A quality of life study in 20 adult long-term survivors of unrelated donor bone marrow transplantation

Marks

Gale

Vedhara

et al. 1999

Bone Marrow Transplant

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Summary:There are few specific data available concerning quality of life (QOL) of survivors of unrelated donor bone marrow transplantation (UD-BMT). The procedure is expensive, difficult and is being employed increasingly yet we have little information concerning the QOL of survivors to justify this intervention. In this study, 20 long-term (Ͼ1 year post-BMT) survivors were studied with four self report questionnaires designed to assess quality of life, satisfaction with life, social support and employment status. Overall, satisfaction with life measures was above average but there was dissatisfaction with physical strength and appearance. The post-transplant employment data indicates that 60% of long-term survivors returned to full-time work and 15% to parttime work. Failure to return to work was not correlated with graft-versus-host disease (GVHD), relapse, age at or time since transplant. In general, there was a good correlation between the clinician's and patient's view of their health but the clinician's assessment of the patients mental health and energy was higher than the patients reported. Further research is required in the area of QOL post-UD-BMT. This will enable transplant physicians to counsel patients better pre-BMT and to evaluate fully the results achieved by different centres performing the procedure. Keywords: unrelated donor BMT; quality of life; employment; long-term survivor; social support Unrelated donor bone marrow transplantation (UD-BMT) is being used with increasing frequency as curative therapy for a variety of haematological malignancies and nonhaematological conditions 1 and results are improving.2 Some recent survival figures reported approach those seen with sibling allografts. 2 A consensus conference has recently debated the role of UD-BMT in the management of haematological diseases, however its use remains controversial amongst haematologists.3 There is still disagreement about outcomes and there are very few data about the quality of life of survivors.

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Unrelated Donor Bone Marrow Transplantation in Adults: Some Current Controversies

Cited by 5 publications

References 32 publications

Disseminated toxoplasmosis after bone marrow transplantation: report of 9 cases

Disseminated toxoplasmosis after bone marrow transplantation: report of 9 cases

Cavernous sinus thrombosis caused by zygomycosis after unrelated bone marrow transplantation

A quality of life study in 20 adult long-term survivors of unrelated donor bone marrow transplantation

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