II. Complications: Infection

  1. T Cells function poorly after transplant for the first 100 days
    1. Higher risk of Viral Infection during this time
  2. Infections otherwise follow a pattern based on time from transplant that is similar to Solid Organ Transplant
    1. Month 1: Nosocomial Infection (e.g. CAUTI, VAP, SSI)
    2. Month 1-6: Opportunistic infection (CMV, EBV, fungal and Parasitic Infections, Tuberculosis)
    3. Month 6+: Community acquired infection (e.g. Pneumonia) and opportunistic infections

III. Complications: Allogenic - Early (first year)

  1. Graft-versus host (severe active, higher risk)
  2. Chronic Diarrhea, malabsorption and Electrolyte abnormalities
  3. Hemorrhagic cystitis
    1. Risk of Acute Renal Failure
    2. Initiate IV fluids
    3. Obtain renal Ultrasound

IV. Complications: Allogenic - Late (10 years post transplant)

  1. Graft-versus-host (chronic, residual)
  2. HPV-mediated oropharyngeal cancer
  3. Lung disease
  4. Growth Hormone Deficiency with Short Stature
  5. Hypogonadism
  6. Hypothyroidism
  7. Basal Cell Carcinoma
  8. Cirrhosis

V. References

  1. Bhatia and Claudius in Herbert (2013) EM:Rap 13(6): 6-7
  2. Claudius, Ruttan and DeFabio in Swadron (2022) EM:Rap 22(11): 13
  3. Bhatia (2012) Pediatrics 130(6): 1141-3 [PubMed]

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Related Studies

Ontology: Bone Marrow Transplantation (C0005961)

Definition (MEDLINEPLUS)

Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The stem cells can develop into red blood cells, which carry oxygen throughout the body, white blood cells, which fight infections, and platelets, which help the to blood clot.

A bone marrow transplant is a procedure that replaces a person's faulty bone marrow stem cells. Doctors use these transplants to treat people with certain diseases, such as

Before you have a transplant, you need to get high doses of chemotherapy and possibly radiation. This destroys the faulty stem cells in your bone marrow. It also suppresses your body's immune system so that it won't attack the new stem cells after the transplant.

In some cases, you can donate your own bone marrow stem cells in advance. The cells are saved and then used later on. Or you can get cells from a donor. The donor might be a family member or unrelated person.

Bone marrow transplantation has serious risks. Some complications can be life-threatening. But for some people, it is the best hope for a cure or a longer life.

NIH: National Heart, Lung, and Blood Institute

Definition (NCI) A procedure to replace diseased or pathologic bone marrow with transplanted healthy bone marrow cells.
Definition (NCI_NCI-GLOSS) A procedure to replace bone marrow that has been destroyed by treatment with high doses of anticancer drugs or radiation. Transplantation may be autologous (an individual's own marrow saved before treatment), allogeneic (marrow donated by someone else), or syngeneic (marrow donated by an identical twin).
Definition (MSH) The transference of BONE MARROW from one human or animal to another for a variety of purposes including HEMATOPOIETIC STEM CELL TRANSPLANTATION or MESENCHYMAL STEM CELL TRANSPLANTATION.
Definition (CSP) transference of bone marrow within an individual, between individuals of the same species, or between individuals of different species.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D016026
ICD9 41.00
SnomedCT 179239002, 149303000, 23719005
LNC LA4278-3
English Bone Marrow Transplantation, Grafting, Bone Marrow, Transplantation, Bone Marrow, Graft of bone marrow NOS, BONE MARROW TRANSPL, TRANSPL BONE MARROW, bone marrow transplant (treatment), bone marrow transplant, Graft of bone marrow NOS (procedure), Bone marrow transplant NOS, Bone marrow trnsplnt NOS, bone marrow grafting, bone marrow transplantations, bone marrow transplant bmt, bmt, bone marrow transplant (BMT), bone marrow transplants, bone marrow graft, Bone marrow transplant (procedure), Grafting of bone marrow NOS, Grafting of bone marrow NOS (procedure), Bone marrow--Transplantation, Bone marrow transplant, NOS, Bone marrow transplant, BMT - Bone marrow transplant, Bone marrow graft, Transplantation of bone marrow (procedure), Transplantation of bone marrow, bone marrow transplantation, transplantation, bone marrow, Transplantation of bone marrow, NOS, Bone Marrow Grafting, BMT, Bone Marrow Transplant, Marrow Transplantation, Bone marrow transplant, not otherwise specified, Transplant;bone marrow
Italian Trapianto di midollo osseo, Trapianto del midollo osseo NAS, Trapianto di midollo spinale
Dutch beenmergtransplantaat NAO, beenmergtransplantaat, Beenmergtransplantatie, Transplantatie, beenmerg-
French Greffe de moelle osseuse SAI, Greffe médullaire (procédure), Transplantation médullaire, Transplantation de moelle osseuse, Greffe de moelle osseuse (procédure), Greffe médullaire, Greffe de moelle osseuse
German Knochenmarktransplantation NNB, Knochenmarkstransplantation, Knochenmarktransplantation, Transplantation, Knochenmark-, Verpflanzung, Knochenmark-, Übertragung, Knochenmark-
Portuguese Transplante de medula óssea NE, Transplante de medula óssea, Enxerto de Medula Óssea, Transplante de Medula Óssea, Transplantação de Medula Óssea
Spanish Trasplante de médula ósea NEOM, injerto de médula ósea, SAI, injerto de médula ósea, SAI (procedimiento), trasplante de médula ósea (procedimiento), trasplante de médula ósea, Trasplante de médula ósea, Injerto de Médula Ósea, Trasplantación de Médula Ósea, Trasplante de Médula Ósea
Japanese 骨髄移植NOS, コツズイイショクNOS, コツズイイショク, 移植-骨髄, 骨髄移植, 骨髄移植術
Swedish Benmärgstransplantation
Finnish Luuytimensiirto
Russian KOSTNOGO MOZGA TRANSPLANTATSIIA, TRANSPLANTATSIIA KOSTNOGO MOZGA, PERESADKA KOSTNOGO MOZGA, КОСТНОГО МОЗГА ТРАНСПЛАНТАЦИЯ, ПЕРЕСАДКА КОСТНОГО МОЗГА, ТРАНСПЛАНТАЦИЯ КОСТНОГО МОЗГА
Czech Transplantace kostní dřeně, Transplantace kostní dřeně NOS, transplantace kostní dřeně, kostní dřeň - transplantace
Croatian KOŠTANA SRŽ, TRANSPLANTACIJA
Polish Przeszczepianie szpiku kostnego, Przeszczep szpiku, Transplantacja szpiku
Hungarian Csontvelő transzplantáció, Csontvelő transzplantáció k.m.n.
Norwegian Beinmargstransplantasjon, Benmargstransplantasjon, Transplantasjon av beinmarg, Transplantasjon, beinmarg