Limitations May Arise After Bone Marrow Transplant

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 Medicine.

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.