Late renal dysfunction in adult survivors of bone marrow transplantation

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From: Cancer(Vol. 67, Issue 11)
Publisher: J.B. Lippincott Company
Document Type: Article
Length: 363 words

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Abstract :

Bone marrow transplantation is becoming more common as a part of cancer treatment, particularly for cancers involving blood cells, such as lymphomas and leukemias. New techniques are constantly evolving which increase the chances of success while at the same time reducing the likelihood of adverse effects of this procedure. However, it is now recognized that a fraction of the patients who have received bone marrow transplantation will develop kidney problems. Unfortunately, it is difficult to determine precisely what causes this kidney damage. In general, cancer patients have been subjected to numerous different treatments, and it is difficult to ascertain which may have contributed the most to the kidney disorder. For example, bone marrow transplant recipients may be affected by the intensive chemotherapy they usually receive before transplantation, by drugs administered to suppress the immune response, by graft-versus-host disease in which the transplanted bone marrow attacks the organs of its new host, and by radiotherapy. In order to determine which of these factors contributes most strongly to the likelihood of kidney disease, a study was undertaken of 103 bone marrow transplant recipients. A total of 14 of these patients developed kidney disease; the complications have led to the death of two patients. Considering the time intervals over which these complications developed, it may be anticipated that 20 percent of patients will experience kidney disease within one year of bone marrow transplantation. While it was difficult to completely rule out any of the possible contributing factors, the most likely culprit in causing the kidney disease seems to be whole-body irradiation. Every patient with kidney disease had received at least 14 Gy of total body irradiation. (A Gy, or Gray, is a dose of radiation equivalent to one joule of energy absorbed per kilogram of tissue. It is equal to 100 rads.) In the present series of patients, 14 had received less than 14 Gy of total body irradiation; none of these patients developed kidney disease. It must be carefully determined if it is possible to shield the kidneys from radiation without impairing the success of the bone marrow transplantation or affecting the relapse rates of the cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Gale Document Number: GALE|A10841953