Hematologic aspects of myeloablative therapy and bone marrow transplantation

Roger S. Riley*, Michael Idowu, Alden Chesney, Shawn Zhao, John McCarty, Lawrence S. Lamb, Jonathan M. Ben-Ezra

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

The transplantation of bone marrow cells or isolated hematopoietic stem cells from the bone marrow or peripheral blood is a widely utilized form of therapy for patients with incurable diseases of the hematopoietic and immune systems. Successful engraftment of the transplanted stem cells in an adequately prepared recipient normally leads to bone marrow reconstitution over a period of several weeks, accompanied by more gradual reconstitution of the immune system. Since the recipient is profoundly ill during the initial treatment period, laboratory data is critical for monitoring engraftment, detecting residual/recurrent disease, and identifying problems that may delay bone marrow reconstitution or lead to other medical complications. Accurate blood cell counts are imperative, and most bone marrow transplantation patients undergo periodic monitoring with bone marrow aspirates and biopsies with cytogenetic, molecular, and multiparametric flow cytometric studies. The potential complications of bone marrow transplantation include engraftment failure and delayed engraftment, infection, residual bone marrow disease, acute and chronic graft versus host disease, myelofibrosis, therapy-related acute leukemia, post-transplant lymphoproliferative disorders, and toxic myelopathy.

Original languageEnglish
Pages (from-to)47-79
Number of pages33
JournalJournal of Clinical Laboratory Analysis
Volume19
Issue number2
DOIs
StatePublished - 2005
Externally publishedYes

Keywords

  • Bone marrow pathology
  • Bone marrow transplantation
  • Complications
  • Graft versus host disease
  • Hematopoietic reconstitution
  • Immunophenotyping
  • Myeloablative therapy

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