Ma. Mccabe et al., NEURODEVELOPMENTAL SIDE-EFFECTS OF BONE-MARROW TRANSPLANTATION - 2 CASE ILLUSTRATIONS OF IDENTICAL-TWINS, Journal of pediatric hematology/oncology, 19(2), 1997, pp. 145-150
Purpose: Bone marrow transplantation (BMT), particularly preparative r
egimens, may have a significant impact on the developing nervous syste
m. However, the effects of various BMT regimens on children's growth a
nd development have been poorly documented to date. Twins serve as ide
al subjects to study the impact of medical treatment, since they contr
ol for nonmedical (genetic and environmental) influences upon neurodev
elopmental outcome. Patients and Methods: Two cases of monozygotic twi
ns are presented to illustrate the impact of BMT regimens. Growth data
and neurocognitive testing are presented for each patient (affected t
win) in relation to his/her syngeneic BMT donor and case control (cont
rol twin). Results: These mio cases illustrate the growth retardation
that has been reported after BMT. However, changes in growth trends ac
ross twins appear to have begun after diagnosis, rather than after BMT
per se. Comparisons of cognitive test results within these twin pairs
illustrate learning problems in the affected twins. However, there wa
s also evidence of learning anomalies in the unaffected twins. Conclus
ions: Results underscore the importance of longitudinal assessment in
order to identify the side effects of BMT regimens for children. Diffe
rences across the two cases highlight important research questions reg
arding variables associated with patients, disease, and treatment (e.g
., age at the time of BMT, previous neurotoxic treatments, underlying
disease) and emphasize the importance of controls in this line of rese
arch.