Nutrition Support of Blood or Marrow Transplant Recipients: How Much Do We Really Know?

84 INTRODUCTION I ntravenous bone marrow infusions have been reported as far back as 1939 (1) with curative attempts for hematologic disease dating to the 1950s (2–3). Since these early investigations, the field of bone marrow transplantation has experienced tremendous growth and advancement, especially in the last two decades. To date, there are over 200 transplant centers in the United States (4), 450 transplant centers worldwide and about 40,000 transplants conducted internationally each year (5). Bone marrow transplantation (BMT) is a sophisticated therapeutic procedure consisting of the administration of chemotherapy and/or radiation therapy followed by intravenous infusion of hematopoietic stem cells to reestablish marrow function (6). It is most frequently used in the treatment of malignant solid tumors and hematologic diseases (Table 1), and generally offers better survival than traditional chemotherapy, despite potentially life-threatening transplant complications (7). As a reflection of technological advances, blood or marrow transplants are now often Nutrition Support of Blood or Marrow Transplant Recipients: How Much Do We Really Know? NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #26