August 2, 2005

Limitations may arise after bone marrow transplant

By Megan Rauscher

NEW YORK (Reuters Health) - Ten percent of long-term
survivors of a bone marrow transplant experience impairment in
functional, social and emotional areas, according to findings
published in the Archives of Pediatrics and Adolescent

Looked at the other way, "this study has a positive message
for clinicians and the children they treat," lead author Dr.
Kirsten K. Ness from the University of Minnesota in Minneapolis
told Reuters Health. The majority (90 percent) of children who
survive a blood cancer or disorder and who have a bone marrow
transplant "go on to lead successful and productive lives."

There is, however, "a subset of children who experience
persistent medical late effects that interfere with physical
independence and participation in social activities," she said.

Ness and her colleagues used a 24-page questionnaire to
assess physical, social and emotional abilities of 235 patients
who underwent bone marrow transplantation before age 21 and
survived at least 2 years afterward, and a matched comparison
group who did not undergo such treatment.

Adult survivors of childhood cancer and bone marrow
transplantation were roughly two times more likely to report
physical limitations, close to three times more likely to
report emotional limitations, and nearly four times more likely
to report physical participation restrictions, than the
comparison group.

They were also significantly less likely to be married.

Child survivors of cancer and bone marrow transplantation
were three times more likely than similarly aged children to
have received special education services and were more than 10
times more likely to have physical participation restrictions.
They also were twice as likely as comparison children to
exhibit behaviors that indicated impaired social skills.

Ness added that individuals who were treated with
radiation, who develop chronic "graft-versus-host" disease, or
who experience heart problems should be carefully monitored.
"They are at greatest risk for functional loss and may benefit
from intervention to restore physical independence and the
ability to participate socially," she said

SOURCE: Archives of Pediatrics and Adolescent Medicine,
August 2005.