Long term survivors of bone marrow transplants have a substantial risk of developing insulin resistance, impaired glucose tolerance and type II diabetes.
Over the last 20 years or so, bone marrow transplantation has been hailed by some as a great medical success in the treatment of childhood cancers.
However, many adverse effects of the procedure have revealed themselves as early recipients have grown into adulthood. These have included gonadal dysfunction, hypothyroidism and stunted growth due to growth hormone deficiency.
In this latest study, involving 23 long term survivors of bone marrow transplantation, 52 per cent had insulin resistance, including impaired glucose tolerance in six survivors and type II diabetes in four. The frequency of these disorders increased with the time since the bone marrow transplantation.
The health of transplant survivors often has to be monitored very carefully.
It now looks as if glucose and insulin levels must be added to the list of regular health checks in this vulnerable group of patients (Lancet, 2000; 356: 993-7).