Constrictive pericarditis post allogeneic bone marrow transplant for Philadelphia-positive acute lymphoblastic leukaemia

We describe two cases of severe constrictive pericarditis arising after all ogeneic BMT conditioning involving total body irradiation and melphalan to treat Philadelphia-chromosome positive ALL, Both patients required pericard ectomy, resulting in marked improvement in ventricular filling. However, a degree of right-sided cardiac failure persisted in both patients secondary to restrictive cardiomyopathy, Constrictive pericarditis has not been previ ously described after BMT, but has been observed following thoracic radioth erapy for malignancy, usually involving a substantially higher radiation do se. Pericardial constriction and restrictive cardiomyopathy should be consi dered as causes of breathlessness and/or oedema occurring late after BMT.