Bone marrow transplantation.

BMT is an effective treatment for certain malignant and nonmalignant conditions. The source of the marrow is autologous or allogeneic. An allogeneic donor can be an HLA-matched related or unrelated donor. The patient undergoes intense chemoradiotherapy to remove remaining malignant cells and obliterate the immune system, thus allowing growth of the new bone marrow cells. Complications of conditioning therapy include pancytopenia and distinct organ toxicities. Astute nursing care is critical in managing the care of BMT patients. Assessment and numerous, interrelated interventions are required. Late complications of BMT relate to the conditioning therapy and to the transplant itself. As BMT becomes more readily available as a treatment, economic issues related to the cost of care and the allocation of resources challenge health care providers.