The clinical consequences of haematological and non-haematological toxicity following bone marrow transplantation and the possible impact of haematopoietic growth factors.

Bone marrow transplantation (BMT) is a rescue therapy used in conjunction with high-dose chemotherapy, which is an effective treatment for overcoming resistant disease in selected malignancies. However, highly intensive preparative regimens produce severe life-threatening toxicity which may be haematological or non-haematological. Despite extensive supportive care including isolation, empiric antibiotic use and parenteral nutrition, toxicity is associated with a significant level of morbidity and mortality. A major cause of morbidity is infection resulting from the period of neutropenia caused by the ablation of the patient's marrow. The haematopoietic growth factors (HGFs) may provide effective therapy for improving haematopoietic reconstitution and therapy decrease the risk of infection, days of hospitalisation and subsequently reducing overall treatment cost. They may also be useful for enhancing neutrophil function, improving bone marrow yield and mobilising peripheral blood progenitor cells (PBPC). Recombinant G-CSF or GM-CSF may, therefore, improve the safety of the BMT procedure and increase its application to a greater number of patients.