Autologous Bone Marrow Transplantation - Blog Science Connections

Toxic Deaths After Autologous Bone Marrow
Transplantations: Rate and Etiology
Eric Bouffet, Pierre Biron, Didier Frappaz, and Thierry Philip
Toxic deaths are the major problem after bone marrow transplantation. The
toxic death rate reported in the world literature after autologous bone marrow
transplantation (ABMT) is in the range of 8-20%. It seems not to be related to
the specific disease, i.e., it is 21% in lymphoma (1,2) and Hodgkin's disease
(3), 20% in neuroblastoma (seeT. Philip et ai, "Bone Marrow Transplantation
in an Unselected Group of 65 Patients With Stage IV Neuroblastoma," in this
volume), 12% in acute myeloid leukemia (4) and Burkitt's lymphoma (see T.
Philip et ai, "Autologous Bone Marrow Transplantation in Burkitt's
Lymphoma: 50 Cases in the Lyons Protocol," in this volume), 10% in
Hodgkin's disease (5), and as low as 8% in breast cancer (6). However, despite
controversy ( 1 ), a slightly but not significantly higher toxic death rate seems
to be related to regimens incorporating total body irradiation (TBI) (Philip,
unpublished data).
Our primary objectives in this retrospective study were to determine the
toxic death rate in a group of 103 patients after ABMT and also to try to
correlate status before ABMT with fatal complications. A secondary objective
was to separate toxic deaths into early (i.e., before day 30 post-ABMT) and
delayed (30-100 days post-ABMT) occurrences.
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