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Autologous bone marrow transplantation. A review of the principles and complications.

High-dose chemotherapy and autologous bone marrow transplantation (ABMT) is now used routinely in an attempt to cure patients with poor-prognosis malignant diseases. This aggressive and intensive treatment requires a highly trained health-care team. Nurses specializing in the care of these patients are essential to maintain patient well-being and ensure a good outcome. High-dose therapy leads to myelosuppression and tissue damage, and the resultant infections, bleeding, and organ toxicities are frequently either unusual or more severe than those seen with conventional-dose antineoplastic therapies. Organ toxicities can affect both short-term and long-term functional status. Disabling or even fatal consequences of treatment can occur during the transplant or months or years later. A specialized knowledge base and an understanding of the way this therapy affects the patient is required not only for the acute inpatient period, but also for the long term. A team approach to these complex patients with a central role for the nurse clinician will lead to optimal patient care.