Skip to main content
NCBI home page
The Yale Journal of Biology and Medicine logoLink to The Yale Journal of Biology and Medicine
. 1990 Sep-Oct;63(5):487–494.

Preparing the patient for bone marrow transplantation: nursing care issues.

W Holmes 1
PMCID: PMC2589372  PMID: 2293507

Abstract

The phases of bone marrow transplantation can be identified as the pre-transplant period, the immediate post-transplant period, and the late post-transplant period. The pre-transplant period is characterized by identification of the appropriate type of transplant to be done and, if necessary, finding an appropriate donor; entry of the patient into the transplant unit; administration of the preparative chemotherapy/irradiation regime; management of early toxicities; and pre-transplant supportive care. Nurses play an integral role during the entire transplant process. During the pre-transplant phase, nursing expertise is exemplified in the administration of chemotherapy, management of side effects, teaching of transplant procedures to patient and family, and supportive care. This paper reviews the patient care issues during the pre-transplant phase of bone marrow transplantation and identifies nursing management strategies.

Full text

PDF
487

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Appelbaum F. R., Sullivan K. M., Buckner C. D., Clift R. A., Deeg H. J., Fefer A., Hill R., Mortimer J., Neiman P. E., Sanders J. E. Treatment of malignant lymphoma in 100 patients with chemotherapy, total body irradiation, and marrow transplantation. J Clin Oncol. 1987 Sep;5(9):1340–1347. doi: 10.1200/JCO.1987.5.9.1340. [DOI] [PubMed] [Google Scholar]
  2. August C. S., King E., Githens J. H., McIntosh K., Humbert J. R., Greensheer A., Johnson R. B. Establishment of erythropoiesis following bone marrow transplantation in a patient with congenital hypoplastic anemia (Diamond-Blackfan syndrome). Blood. 1976 Oct;48(4):491–498. [PubMed] [Google Scholar]
  3. Bensinger W. I., Buckner C. D., Thomas E. D., Clift R. A. ABO-incompatible marrow transplants. Transplantation. 1982 Apr;33(4):427–429. doi: 10.1097/00007890-198204000-00017. [DOI] [PubMed] [Google Scholar]
  4. Bortin M. M., Gale R. P., Rimm A. A. Allogeneic bone marrow transplantation for 144 patients with severe aplastic anemia. JAMA. 1981 Mar 20;245(11):1132–1139. [PubMed] [Google Scholar]
  5. Braine H. G., Sensenbrenner L. L., Wright S. K., Tutschka P. J., Saral R., Santos G. W. Bone marrow transplantation with major ABO blood group incompatibility using erythrocyte depletion of marrow prior to infusion. Blood. 1982 Aug;60(2):420–425. [PubMed] [Google Scholar]
  6. Brand A., Claas F. H., Falkenburg J. H., van Rood J. J., Eernisse J. G. Blood component therapy in bone marrow transplantation. Semin Hematol. 1984 Apr;21(2):141–155. [PubMed] [Google Scholar]
  7. Buckner C. D., Clift R. A., Sanders J. E., Meyers J. D., Counts G. W., Farewell V. T., Thomas E. D. Protective environment for marrow transplant recipients: a prospective study. Ann Intern Med. 1978 Dec;89(6):893–901. doi: 10.7326/0003-4819-89-6-893. [DOI] [PubMed] [Google Scholar]
  8. Canellos G. P., Nadler L., Takvorian T. Autologous bone marrow transplantation in the treatment of malignant lymphoma and Hodgkin's disease. Semin Hematol. 1988 Apr;25(2 Suppl 2):58–65. [PubMed] [Google Scholar]
  9. Carl W., Higby D. J. Oral manifestations of bone marrow transplantation. Am J Clin Oncol. 1985 Feb;8(1):81–87. doi: 10.1097/00000421-198502000-00053. [DOI] [PubMed] [Google Scholar]
  10. Champlin R. E., Gale R. P. Role of bone marrow transplantation in the treatment of hematologic malignancies and solid tumors: critical review of syngeneic, autologous, and allogeneic transplants. Cancer Treat Rep. 1984 Jan;68(1):145–161. [PubMed] [Google Scholar]
  11. Champlin R. E., Gale R. P. The early complications of bone marrow transplantation. Semin Hematol. 1984 Apr;21(2):101–108. [PubMed] [Google Scholar]
  12. Champlin R. E., Ho W. G., Gale R. P., Winston D., Selch M., Mitsuyasu R., Lenarsky C., Elashoff R., Zighelboim J., Feig S. A. Treatment of acute myelogenous leukemia. A prospective controlled trial of bone marrow transplantation versus consolidation chemotherapy. Ann Intern Med. 1985 Mar;102(3):285–291. doi: 10.7326/0003-4819-102-3-285. [DOI] [PubMed] [Google Scholar]
  13. Champlin R., Ho W., Arenson E., Gale R. P. Allogeneic bone marrow transplantation for chronic myelogenous leukemia in chronic or accelerated phase. Blood. 1982 Oct;60(4):1038–1041. [PubMed] [Google Scholar]
  14. Clift R. A., Buckner C. D., Thomas E. D., Doney K., Fefer A., Neiman P. E., Singer J., Sanders J., Stewart P., Sullivan K. M. Treatment of chronic granulocytic leukaemia in chronic phase by allogeneic marrow transplantation. Lancet. 1982 Sep 18;2(8299):621–623. doi: 10.1016/s0140-6736(82)92735-0. [DOI] [PubMed] [Google Scholar]
  15. Coccia P. F., Krivit W., Cervenka J., Clawson C., Kersey J. H., Kim T. H., Nesbit M. E., Ramsay N. K., Warkentin P. I., Teitelbaum S. L. Successful bone-marrow transplantation for infantile malignant osteopetrosis. N Engl J Med. 1980 Mar 27;302(13):701–708. doi: 10.1056/NEJM198003273021301. [DOI] [PubMed] [Google Scholar]
  16. Dinsmore R., Kirkpatrick D., Flomenberg N., Gulati S., Kapoor N., Shank B., Reid A., Groshen S., O'Reilly R. J. Allogeneic bone marrow transplantation for patients with acute lymphoblastic leukemia. Blood. 1983 Aug;62(2):381–388. [PubMed] [Google Scholar]
  17. Dudjak L. A. HLA typing: implications for nurses. Oncol Nurs Forum. 1984 Sep-Oct;11(5):30–36. [PubMed] [Google Scholar]
  18. Fetting J. H., Grochow L. B., Folstein M. F., Ettinger D. S., Colvin M. The course of nausea and vomiting after high-dose cyclophosphamide. Cancer Treat Rep. 1982 Jul;66(7):1487–1493. [PubMed] [Google Scholar]
  19. Ford R., Ballard B. Acute complications after bone marrow transplantation. Semin Oncol Nurs. 1988 Feb;4(1):15–24. doi: 10.1016/0749-2081(88)90052-6. [DOI] [PubMed] [Google Scholar]
  20. Freedman S. E. An overview of bone marrow transplantation. Semin Oncol Nurs. 1988 Feb;4(1):3–8. doi: 10.1016/0749-2081(88)90050-2. [DOI] [PubMed] [Google Scholar]
  21. Freedman S. E. An overview of bone marrow transplantation. Semin Oncol Nurs. 1988 Feb;4(1):3–8. doi: 10.1016/0749-2081(88)90050-2. [DOI] [PubMed] [Google Scholar]
  22. Gale R. P., Feig S., Ho W., Falk P., Rippee C., Sparkes R. ABO blood group system and bone marrow transplantation. Blood. 1977 Aug;50(2):185–194. [PubMed] [Google Scholar]
  23. Haberman M. R. Psychosocial aspects of bone marrow transplantation. Semin Oncol Nurs. 1988 Feb;4(1):55–59. doi: 10.1016/0749-2081(88)90057-5. [DOI] [PubMed] [Google Scholar]
  24. Helson L. Autologous bone marrow transplantation. A maximal therapy design for disseminated neuroblastoma. Am J Pediatr Hematol Oncol. 1985 Spring;7(1):45–50. [PubMed] [Google Scholar]
  25. Holland J., Plumb M., Yates J., Harris S., Tuttolomondo A., Holmes J., Holland J. F. Psychological response of patients with acute leukemia to germ-free environments. Cancer. 1977 Aug;40(2):871–879. doi: 10.1002/1097-0142(197708)40:2<871::aid-cncr2820400241>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  26. Hutchison M. M., King A. H. A nursing perspective on bone marrow transplantation. Nurs Clin North Am. 1983 Sep;18(3):511–522. [PubMed] [Google Scholar]
  27. Johnson F. L., Look A. T., Gockerman J., Ruggiero M. R., Dalla-Pozza L., Billings F. T., 3rd Bone-marrow transplantation in a patient with sickle-cell anemia. N Engl J Med. 1984 Sep 20;311(12):780–783. doi: 10.1056/NEJM198409203111207. [DOI] [PubMed] [Google Scholar]
  28. Kamani N., August C. S. Bone marrow transplantation. Problems and prospects. Med Clin North Am. 1984 May;68(3):657–674. doi: 10.1016/s0025-7125(16)31121-x. [DOI] [PubMed] [Google Scholar]
  29. Levine A. S., Siegel S. E., Schreiber A. D., Hauser J., Preisler H., Goldstein I. M., Seidler F., Simon R., Perry S., Bennett J. E. Protected environments and prophylactic antibiotics. A prospective controlled study of their utility in the therapy of acute leukemia. N Engl J Med. 1973 Mar 8;288(10):477–483. doi: 10.1056/NEJM197303082881001. [DOI] [PubMed] [Google Scholar]
  30. Lindgren P. S. The laminar air flow room. Nursing practices and procedures. Nurs Clin North Am. 1983 Sep;18(3):553–561. [PubMed] [Google Scholar]
  31. Lucarelli G., Galimberti M., Polchi P., Giardini C., Politi P., Baronciani D., Angelucci E., Manenti F., Delfini C., Aureli G. Marrow transplantation in patients with advanced thalassemia. N Engl J Med. 1987 Apr 23;316(17):1050–1055. doi: 10.1056/NEJM198704233161703. [DOI] [PubMed] [Google Scholar]
  32. Nesbit M. E., Jr, Woods W. G., Weisdorf D., Filipovich A. H., LeBien T. W., Kersey J. H., Ramsay N. K. Bone marrow transplantation for acute lymphocytic leukemia. Semin Oncol. 1985 Jun;12(2):149–159. [PubMed] [Google Scholar]
  33. O'Reilly R. J. Allogenic bone marrow transplantation: current status and future directions. Blood. 1983 Nov;62(5):941–964. [PubMed] [Google Scholar]
  34. O'Reilly R. J., Brochstein J., Dinsmore R., Kirkpatrick D. Marrow transplantation for congenital disorders. Semin Hematol. 1984 Jul;21(3):188–221. [PubMed] [Google Scholar]
  35. Parkman R., Rappeport J., Geha R., Belli J., Cassady R., Levey R., Nathan D. G., Rosen F. S. Complete correction of the Wiskott-Aldrich syndrome by allogeneic bone-marrow transplantation. N Engl J Med. 1978 Apr 27;298(17):921–927. doi: 10.1056/NEJM197804272981701. [DOI] [PubMed] [Google Scholar]
  36. Petersen F. B., Buckner C. D., Clift R. A., Lee S., Nelson N., Counts G. W., Meyers J. D., Sanders J. E., Stewart P. S., Bensinger W. I. Laminar air flow isolation and decontamination: a prospective randomized study of the effects of prophylactic systemic antibiotics in bone marrow transplant patients. Infection. 1986 May-Jun;14(3):115–121. doi: 10.1007/BF01643474. [DOI] [PubMed] [Google Scholar]
  37. Rappeport J. M., Ginns E. I. Bone-marrow transplantation in severe Gaucher's disease. N Engl J Med. 1984 Jul 12;311(2):84–88. doi: 10.1056/NEJM198407123110203. [DOI] [PubMed] [Google Scholar]
  38. Ruggiero M. R. The donor in bone marrow transplantation. Semin Oncol Nurs. 1988 Feb;4(1):9–14. doi: 10.1016/0749-2081(88)90051-4. [DOI] [PubMed] [Google Scholar]
  39. Santos G. W. History of bone marrow transplantation. Clin Haematol. 1983 Oct;12(3):611–639. doi: 10.1016/s0308-2261(83)80003-4. [DOI] [PubMed] [Google Scholar]
  40. Saral R., Burns W. H., Laskin O. L., Santos G. W., Lietman P. S. Acyclovir prophylaxis of herpes-simplex-virus infections. N Engl J Med. 1981 Jul 9;305(2):63–67. doi: 10.1056/NEJM198107093050202. [DOI] [PubMed] [Google Scholar]
  41. Slichter S. J. Transfusion and bone marrow transplantation. Transfus Med Rev. 1988 Mar;2(1):1–17. doi: 10.1016/s0887-7963(88)70027-9. [DOI] [PubMed] [Google Scholar]
  42. Speck B., Gratwohl A., Osterwalder B., Nissen C. Bone marrow transplantation for chronic myeloid leukemia. Semin Hematol. 1984 Jan;21(1):48–52. [PubMed] [Google Scholar]
  43. Storb R., Prentice R. L., Buckner C. D., Clift R. A., Appelbaum F., Deeg J., Doney K., Hansen J. A., Mason M., Sanders J. E. Graft-versus-host disease and survival in patients with aplastic anemia treated by marrow grafts from HLA-identical siblings. Beneficial effect of a protective environment. N Engl J Med. 1983 Feb 10;308(6):302–307. doi: 10.1056/NEJM198302103080602. [DOI] [PubMed] [Google Scholar]
  44. Storb R., Thomas E. D., Buckner C. D., Appelbaum F. R., Clift R. A., Deeg H. J., Doney K., Hansen J. A., Prentice R. L., Sanders J. E. Marrow transplantation for aplastic anemia. Semin Hematol. 1984 Jan;21(1):27–35. [PubMed] [Google Scholar]
  45. Sullivan K. M., Deeg H. J., Sanders J. E., Shulman H. M., Witherspoon R. P., Doney K., Appelbaum F. R., Schubert M. M., Stewart P., Springmeyer S. Late complications after marrow transplantation. Semin Hematol. 1984 Jan;21(1):53–63. [PubMed] [Google Scholar]
  46. Thomas E. D., Buckner C. D., Banaji M., Clift R. A., Fefer A., Flournoy N., Goodell B. W., Hickman R. O., Lerner K. G., Neiman P. E. One hundred patients with acute leukemia treated by chemotherapy, total body irradiation, and allogeneic marrow transplantation. Blood. 1977 Apr;49(4):511–533. [PubMed] [Google Scholar]
  47. Thomas E. D., Buckner C. D., Clift R. A., Fefer A., Johnson F. L., Neiman P. E., Sale G. E., Sanders J. E., Singer J. W., Shulman H. Marrow transplantation for acute nonlymphoblastic leukemia in first remission. N Engl J Med. 1979 Sep 13;301(11):597–599. doi: 10.1056/NEJM197909133011109. [DOI] [PubMed] [Google Scholar]
  48. Thomas E. D., Clift R. A., Buckner C. D. Marrow transplantation for patients with acute nonlymphoblastic leukemia who achieve a first remission. Cancer Treat Rep. 1982 Jul;66(7):1463–1466. [PubMed] [Google Scholar]
  49. Thomas E. D. High-dose therapy and bone marrow transplantation. Semin Oncol. 1985 Dec;12(4 Suppl 6):15–20. [PubMed] [Google Scholar]
  50. Thomas E. D. Karnofsky Memorial Lecture. Marrow transplantation for malignant diseases. J Clin Oncol. 1983 Sep;1(9):517–531. doi: 10.1200/JCO.1983.1.9.517. [DOI] [PubMed] [Google Scholar]
  51. Zwaan F. E., Jansen J. Bone marrow transplantation in acute nonlymphoblastic leukemia. Semin Hematol. 1984 Jan;21(1):36–42. [PubMed] [Google Scholar]
  52. de Graan-Hentzen Y. C., Gratama J. W., Mudde G. C., Verdonck L. F., Houbiers J. G., Brand A., Sebens F. W., van Loon A. M., The T. H., Willemze R. Prevention of primary cytomegalovirus infection in patients with hematologic malignancies by intensive white cell depletion of blood products. Transfusion. 1989 Nov-Dec;29(9):757–760. doi: 10.1046/j.1537-2995.1989.29990070177.x. [DOI] [PubMed] [Google Scholar]

Articles from The Yale Journal of Biology and Medicine are provided here courtesy of Yale Journal of Biology and Medicine

RESOURCES