Late effects after allogeneic bone marrow transplantation.

Late effects are delayed side effects that can occur months or years after bone marrow transplantation. Late effects become a matter of concern as the number of surviving patients and the length of survival time increase. Late effects express themselves as structural or functional impairment of organs or tissues or as neoplastic growth secondary to the primary treatment. Non-neoplastic late effects affect growth and development in children; endocrine and reproductive function; and the function of the eyes, lungs, kidneys, and other organs. Secondary neoplasms are malignant lymphomas and leukemias that occur early after transplantation. Solid tumors develop later and primarily involve skin and mucous membranes. Intensive chemotherapy and radiotherapy and chronic graft-versus-host disease and its immunosuppressive treatment are potential risk factors. Psychosocial rehabilitation is incomplete in a proportion of these patients. Further investigation is necessary for improvement in the prophylaxis and treatment of late effects.