Patients with morbid obesity don't get life-saving bone marrow transplants

被引:11
作者
Clarke, B [1 ]
Engler, H [1 ]
机构
[1] Dept Vet Affairs, Med Ctr, Augusta, GA USA
关键词
bariatric surgery; bone marrow transplantation; chronic myelogenous leukemia; gastric bypass; morbid obesity; peripheral stem-cell transplant;
D O I
10.1381/096089299765553863
中图分类号
R61 [外科手术学];
学科分类号
摘要
When the patient, a registered nurse, was surgically treated for morbid obesity she initially lost 54.5 kg. Approximately 2 years after gastric bypass, she received a diagnosis of chronic myelogenous leukemia and subsequently underwent a successful allogenic bone marrow transplant (BMT). When her surgical history was taken at the transplant facility, the significant weight loss and gastric bypass were discussed. She was informed that at 140 kg, she would not have been eligible nor considered a candidate for transplant. A search of the literature and a survey of other facilities confirmed this view as typical. The reasons cited were that the chemotherapy dosage required for the morbidly obese weight level would cause fatal organ damage as opposed to organ-sparing dosages, which would not eradicate all leukemic cancer cells. An additional general view was that the morbidly obese could not survive the rigors of the transplant preoperative regimen. This patient had an uneventful recovery and remains disease-free today, 3 years after BMT and 5 years after gastric bypass, with a sustained total weight loss of 73 kg.
引用
收藏
页码:77 / 79
页数:3
相关论文
共 12 条
[1]
*AR BEN SOL INC, 1995, VERD VALL SCH EMPL B
[2]
Successful allogeneic bone marrow transplantation in selected patients over 50 years of age - a single institution's experience [J].
Du, W ;
Dansey, R ;
Abella, EM ;
Baynes, R ;
Peters, WP ;
Klein, J ;
Akhtar, A ;
Cherednikova, L ;
Karanes, C .
BONE MARROW TRANSPLANTATION, 1998, 21 (10) :1043-1047
[3]
Enright H, 1996, BONE MARROW TRANSPL, V17, P537
[4]
Hrabanek J, 1995, Vnitr Lek, V41, P682
[5]
Factors influencing the outcome of bone marrow transplants using unrelated donors [J].
Madrigal, JA ;
Scott, I ;
Arguello, R ;
Szydlo, R ;
Little, AM ;
Goldman, JM .
IMMUNOLOGICAL REVIEWS, 1997, 157 :153-166
[6]
QUILITZ R, 1998, COMMUNICATION 0611
[7]
RANDOLPH DR, 1998, COMMUNICATION 0508
[8]
Allogeneic bone marrow transplantation [J].
Tabbara, IA .
SOUTHERN MEDICAL JOURNAL, 1996, 89 (09) :857-868
[9]
*TRANSPL SERV STAN, 1996, 18475 DAR TRANSPL SE
[10]
WEINBERGER BB, 1998, COMMUNICATION 0610