see: [Dunn - Bone marrow transplant](x-devonthink-item://6B82D893-7FEF-492F-B638-D3CA54A6BD12) #incomplete # Complications ## infections - varicella-zoster - pneumocystis carinii -- usually on ppx - vaccines -- do NOT use live vaccines within 2 years of transplantation (eg MMR), avoid children who have had an oral polio vaccine for one month following vaccination ## Graft vs host disease GVHD - activation of donor T cells in the transplanted marrow that cause tissue damage - only following *allogenic transplants* Acute - < 100 days following transplants chronic - > 100 days (usually within 2 years) - ↑ risk of infection - mucositis - vitilago - scleroderma **management** - glucocorticoids - tacrolimus - ciclosporin ## endocrine - [[Hypothyroidism]] in 25% 2/2 total body irradiation - thyroid adenomas and carcinomas - gonadal dysfunction / infertility - osteoporosis