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Bone Marrow Transplant Complications

Bone marrow is the red and yellow spongy-looking material found in the middle of large bones. Bone marrow contains stem cells that become red blood cells, white blood cells and platelets. Before a bone marrow transplant, high doses of chemotherapy and radiation are given to destroy the marrow, thereby compromising the immune system, which lowers the risk of the body rejecting the new bone marrow. The destruction of the immune system--added to chemotherapy and radiation treatments--leaves the body defenseless against complications.

  1. Infection

    • The most common complication, and one that can be life-threatening, is infection. Because the body's immune system is compromised, the risk of infection is very high. As the body recovers and new white blood cells are produced by the new bone marrow, the risks are reduced. However, for the first three months, up to a year after surgery, report any suspicious symptoms to your doctor.

    Veno-occlusive Disease

    • Veno-occlusive disease (VOD) is a complication involving the liver or kidneys that usually occurs within 20 days of the bone marrow transplant. Radiation and chemotherapy treatments can cause a buildup of dead cells that block the blood vessels of these organs. About half of all bone marrow transplant patients develop this complication--which can be deadly. Those at highest risk are patients with pre-existing liver disease, infections or those taking antibiotics at the same time as their chemotherapy treatments.

    Graft Versus Host Disease

    • Graft versus host disease (GVHD) occurs when the newly transplanted bone marrow cells reject the body. In acute GVHD, the condition begins within 100 days of the bone marrow transplant. In chronic GVHD, it may not surface until 3 to 12 months after the transplant. The condition usually starts as a skin rash that progresses to involve the liver and intestinal tract. Preventative medication is given to transplant patients to combat this condition before it can begin. Once this complication develops, it is usually treatable but can be life-threatening.

    Lack of Engraftment

    • A lack of engraftment means the transplanted stem cells fail to mature, grow and differentiate. This can be caused by the other complications; for example, an infection. Medication can be administered to stimulate the new cells to grow.

    Other Complications

    • Platelets, cells that aid in blood clotting, are produced by the bone marrow. Because chemotherapy destroys the existing bone marrow cells, the number of platelets produced declines, which can result in bleeding.

      Infections can affect the ability of the heart and lungs to function normally.

      Because of the high doses of chemotherapy and radiation required with a bone marrow transplant, infertility is often an unwanted side effect.

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