Overview of Conditioning Related Life-Threatening Toxicities of Marrow Transplantation

Abstract

Chemotherapeutic agents used for blood and marrow transplantation are administered at doses up to 10 times greater than what would be used in conventional treatment of malignancies. This aggressive use of chemotherapy, with or without concomitant radiation, is associated with multiple organ toxicities. Common, and frequently life-threatening toxicities include cardiac toxicity, veno-occlusive disease of the liver, idiopathic pneumonia, neurotoxicity, renal failure, and oral mucositis. Often these toxicities are difficult to distinguish from other treatment-related complications, such as infection. The precise mechanisms of these injuries are poorly understood, but may relate to depletion of antioxidants. Although preventative strategies do not appear to be particularly effective, prompt recognition of the problems may be life-saving.