Evolution of consultation-liaison services in bone marrow transplantation.

Bone marrow transplantation offers new hope for cure in a variety of leukemias, aplastic anemia, and other immunodeficiency and hematologic disorders. But the psychologic circumstances accompanying this procedure are often profoundly stressful. The evolution of consultation--liaison services on a bone marrow transplantation unit are described and illustrated with several clinical vignettes. The results of a survey of 52 other bone marrow transplantation centers report the percentage that provide such services and the extent to which they are performed by a psychiatrist, a nonphysician psychosocial counselor, or both.