Abstract
Bone marrow and haematopoietic stem cell transplants (HSCT) are used both to treat haematological malignancies and, to a lesser extent, benign disease. They may use a recipient’s own cells (autograft) or those from an HLA-matched donor (allograft). This chapter discusses indications for transplant, principles of the procedure and the different complications that may occur, either from the pre-HSCT chemotherapy or the transplant itself. These are divided into those that occur in the 21 days pre-engraftment, ‘early’ complications at day 21 to 100 and ‘late’ complications thereafter. Although the GI tract is most commonly affected at every stage, other organs (liver, skin) can be involved and there is an increased risk of infections throughout. Nutritional assessment and appropriate support (ideally with oral or enteral nutrition) is vital. Parenteral nutrition should be reserved for those whose requirements cannot be met and should be stopped when possible due to infective and metabolic complications.
Maria Gilleece has died before the publication of this book.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Carreras E, Dufour C, Mohty M, Kröger N. The EBMT handbook: hematopoietic stem cell transplantation and cellular therapies. Cham: Springer; 2019.
Abutalib SA, Hari P. Clinical manual of blood and bone marrow transplantation. London: Wiley Blackwell; 2017.
Jessop H, Farge D, Sccardi R, et al. General information for patients and carers considering haematopoietic stem cell transplantation (HSCT) for severe autoimmune diseases (ADs): a position statement from the EBMT Autoimmune Diseases Working Party (ADWP), the EBMT Nurses Group, the EBMT Patient, Family and Donor Committee and the Joint Accreditation Committee of ISCT and EBMT (JACIE). Bone Marrow Transplant. 2019;54:933–42.
Passweg JR, Baldomero H, Chabannon C, et al. The EBMT activity survey on hematopoietic-cell transplantation and cellular therapy 2018: CAR-T’s come into focus. Bone Marrow Transplant. 2020;55:1604. https://doi.org/10.1038/s41409-020-0826-4.
BSBMT. Indications table. n.d.. http://bsbmtct.org/indications-table/.
Berger MJ, Ettinger DS, Aston J, et al. NCCN guidelines insights: antiemesis, version 2.2017. J Natl Compr Cancer Netw. 2017;15(7):883–93.
Blijlevens NM, Donnelly JP, De Pauw BE. Mucosal barrier injury: biology, pathology, clinical counterparts and consequences of intensive treatment for haematological malignancy: an overview. Bone Marrow Transplant. 2000;25:1269–78.
Wilkes JD. Prevention and treatment of oral mucositis following cancer therapy. Semin Oncol. 1998;25:538–51.
BDA. Policy statement: neutropenic dietary advice for haematology patients. Birmingham: BDA: The Association of UK Dieticians; 2013.
Rodrigues FG, Dasilva G, Wexner SD. Neutropenic enterocolitis. World J Gastroenterol. 2017;23(1):42–7.
Carreras E, Bertz H, Arcese W. Incidence and outcome of hepatic veno-occlusive disease after blood or marrow transplantation: a prospective cohort study of the European Group for Blood and Marrow Transplantation. European Group for Blood and Marrow Transplantation Chronic Leukemia Working Party. Blood. 1998;92(10):3599–604.
Fan CQ, Crawford JM. Sinusoidal obstruction syndrome (hepatic veno-occlusive disease). J Clin Exp Hepatol. 2014;4(4):332–46.
Mohty M, et al. Revised diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a new classification from the European society for blood and marrow transplantation. Bone Marrow Transplant. 2016;51(7):906–12.
Richardson PG, Riches ML, Kernan NA, et al. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood. 2016;127(13):1656–65.
Lortholary O, Gangneux JP, Sitbon K, et al. Epidemiological trends in invasive aspergillosis in France: the SAIF network (2005–2007). Clin Microbiol Infect. 2011;17:1882–9.
Marty FM, Ljungman P, Chemaly RF, et al. Letermovir prophylaxis for cytomegalovirus in hematopoietic-cell transplantation. N Engl J Med. 2017;377(25):2433–44.
Snover DC, Weisdorf SA, Vercellotti GM, et al. A histopathologic study of gastric and small intestinal graft-versus-host disease following allogeneic bone marrow transplantation. Hum Pathol. 1985;16:387–92.
Glucksberg H, Storb R, Fefer A, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation. 1974;18:295–304.
Jagasia M, Greinix H, Robin M, et al. Extracorporeal photopheresis versus anticytokine therapy as a second line treatment for steroid-refractory acute GVHD: a multicenter comparative analysis. Biol Blood Marrow Transpl. 2013;19:1129–33.
Philippe Armand P, Kim HT, Virtanen JM, et al. Iron overload in allogeneic hematopoietic cell transplantation outcome: a meta-analysis. Biol Blood Marrow Transpl. 2014;20(8):1248–51.
Baumgartner A, Bargetzi A, Zueger N, et al. Revisiting nutritional support for allogeneic hematologic stem cell transplantation-a systematic review. Bone Marrow Transplant. 2017;52:506–13.
August DA, Huhmann MB, American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. A.S.P.E.N. Clinical Guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. J Parent Ent Nutr. 2009;33(5):472.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Clay, J., Gilleece, M., Donnellan, C. (2023). Bone Marrow and Haemopoietic Stem Cell Transplantation. In: Nightingale, J.M. (eds) Intestinal Failure. Springer, Cham. https://doi.org/10.1007/978-3-031-22265-8_9
Download citation
DOI: https://doi.org/10.1007/978-3-031-22265-8_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-22264-1
Online ISBN: 978-3-031-22265-8
eBook Packages: MedicineMedicine (R0)