Jaundice following bone marrow transplantation. The problem of diagnosis.

Jaundice presented a major diagnostic and therapeutic problem in 6 out of 20 patients undergoing allogeneic bone marrow transplantation for severe acute aplastic anaemia or leukaemia in relapse. In the first 2 cases histological features of graft-versus-host disease were demonstrable in the skin but absent in the liver. In the 3rd case B-virus hepatitis was the most likely diagnosis, in the 4th cumulative cytotoxic chemotherapy was incriminated, and in the last 2 cases the jaundice was obstructive. These 6 cases illustrate the varied causation of jaundice in patients undergoing bone marrow transplantation, and emphasize that correct diagnosis is essential for rational management.