As marrow transplantation has been used more frequently and with greater success, the number of long-term survivors has grown steadily. Consequently, the probability of detecting long-term side effects of marrow transplantation has increased. As described above, patients are usually prepared for transplantation by the administration of high doses of immunosuppressive/cytotoxic agents and TBI given either alone or in combination. Following the transplant procedure, patients go through a period of profound immunoincompetence. In addition, most of them receive immunosuppressive drugs such as methotrexate, cyclo-sporine or, methylprednisolone, in an attempt to prevent or treat GVHD. Cytotoxic agents, ionizing irradiation, and the use of immunosuppressive drugs are known to be associated with an increased risk of developing malignancies. Malignant tumors have been observed in patients given immunosuppressive treatment after renal or cardiac transplantation. Furthermore, a high incidence of malignant lymphomas has been observed in F1 hybrid mice given parental hemo-poietic grafts. Consequently, there has been concern that patients given TBI and marrow grafts might also be at increased risk of developing secondary malignancies. Studies in dogs and rhesus monkeys given allogeneic or autologous marrow grafts have, indeed, shown an increased incidence of malignant tumors as compared to control animals.
KeywordsBone Marrow Transplantation Marrow Transplantation Basal Cell Carcinoma Donor Cell Lymphoproliferative Disorder
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