PATIENTS who undergo bone marrow transplants usually undergo total-body irradiation of up to 14 Gy. Unfortunately, this radiation spares no part of the body, panelist Peter Tutschka, MD, professor of medicine and pathology and director of the Bone Marrow Transportation Division, Ohio State University, Columbus, told the American Cancer Society seminar in Phoeniz. Severe and often intractable nausea and vomiting followed by diarrhea attests to the toxicity on the gastrointestinal tract, he says. Among other adverse effects are damage to the lungs, liver, kidney, central nervous system, and endocrine glands that leads to sterility in adults and impaired sexual development and stunted growth in children. Radiation also impairs the microenvironment for the marrow graft to develop, which leads to delayed recovery of marrow function and a resulting high rate of infections and bleeding problems. Despite these tremendous side effects, total-body irradiation is not a very effective antileukemic agent, he says,
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