Abstract
Chemotherapeutic agents used for blood and marrow transplantation are administered
at doses up to 10 times greater than what would be used in conventional treatment
of malignancies. This aggressive use of chemotherapy, with or without concomitant
radiation, is associated with multiple organ toxicities. Common, and frequently life-threatening
toxicities include cardiac toxicity, veno-occlusive disease of the liver, idiopathic
pneumonia, neurotoxicity, renal failure, and oral mucositis. Often these toxicities
are difficult to distinguish from other treatment-related complications, such as infection.
The precise mechanisms of these injuries are poorly understood, but may relate to
depletion of antioxidants. Although preventative strategies do not appear to be particularly
effective, prompt recognition of the problems may be life-saving.