Post Transplant Confusion - Leukemia Message Board

martid100 · 08-08-2002, 10:50 AM

My sister, 41 yoa, received her bone marrow transplant at Duke two weeks ago. Transplant is doing fine, however, this past Thursday she was placed in ICU for breathing problems. Things looks very grim for several days as more and more of her organs were failing (kidneys, liver, lungs, heart). Although the doctors reports were getting grimmer and grimmer, God, working through the doctors using imunoglobulin snatched her from the jaws of death. She is going back to the BMT unit today. Anyway, although she is doing much better organwise, she is still very confused, enough to maintain the restraints on her arms to keep her from tearing out her tubes. The doctors don't know the cause of the confusion but are decreasing her pain medication to see if that helps. Anybody who experienced confusion as part of their complications? If so, how long did it last? Result of pain meds?

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Jay Tor · 08-08-2002, 11:53 AM

Hi:

My child had a BMT for AML and was given Dilantin prophylactically to prevent seizures that can occur with Busulfan. PCA Morphine produced hallucinogenic episodes and nightmares/night terrors even at low doses relative to body weight. [Morphine/opiate sensitivity tends to run in families, ask your family about this.] Another possibility is HLA incompatibility of any blood products your sister may have received. HLA incompatibility can cause seizures and even a transfusion-GVHD reaction.

Organ crises/failures don't happen often but the BMT team usually includes the major specialties [Cardiologist, Nephrologist, Liver, etc.] to monitor this. From what I've heard, organ crises tend to occur when there's been a previous trauma/illness affecting that organ. A few of the BMT work-up or 'conditioning' chemo meds tend to target some organs more than others. Which organ depends on the cell/tissue type which, in turn, depends on specific proteins forming those structures, etc., so that's another possibility.

Suggest you try the BMT list members at ACOR.org for other ideas. If you have your sister's PDQ, you can look it up at the link below to see whether these are documented side-effects or possible overdoses:

National Cancer Institute (NCI) CancerNet Database - Main Index
[url="http://imsdd.meb.uni-bonn.de/cancernet/cancernet.html"]http://imsdd.meb.uni-bonn.de/cancernet/cancernet.html[/url]