The bone marrow transplant patient receives many treatments which may have serious
side effects on many organs, including chemotherapy, radiation and some of the
medications used for controlling GvHD and infections. Sometimes the side effects
are harmful to the heart, lungs, liver or kidneys.
Throughout the transplant process, the child is continuously assessed and various
blood and
x-ray tests are done to monitor for toxicity. Some side effects may not be
seen for months to years later, and routine testing is done in the outpatient
clinic to follow for various organ toxicities (see routine follow-up care outline).
Rejection of the Transplant
Some patients do not engraft following transplant and this is referred to
as rejection. This means the marrow from the donor did not grow, and usually
the patient's own original marrow grows back in its place. Some children show
signs of good engraftment initially, but ultimately reject the donor marrow.
Should this occur, the medical team will review that patient's overall status
and present options or recommendations for treatment. For most children, a second
transplant may be an option, but this is not the case for every child.
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