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Child abuse: an indirect consequence of failure of bone marrow transplantation

Bone Marrow Transplantation volume 35, pages 825–826 (2005)Cite this article

Allogeneic bone marrow transplantation has become a popular treatment for patients with thalassaemia major. The majority of patients are cured after transplantation and recommended strategies are available to guide management of iron toxicities and other complications of the transplant. However, the negative outcomes of the minority of patients who fail to engraft have not been systematically examined. The experience of physical maltreatment in an adolescent thalassaemic girl after engraftment failure suggests that the physical and psychosocial needs of the latter patients deserve further study.

A 13-year-old girl with thalassaemia major returned to our care after she failed a matched sibling bone marrow transplantation and became thalassaemic again. She was born in mainland China from a crossborder marriage. Her father was a resident in Hong Kong, while the patient, her mother, and three younger siblings lived in mainland China. Her illness started at 6 months of age and she had been treated with regular blood transfusion since, with a usual trough haemoglobin of 7 g/dl, without any iron chelation therapy. At the age of 11 years, the family reunited in Hong Kong and the patient attended our hospital for blood transfusion therapy. At that time, she was noted to have the typical stigmata of thalassaemia, including the typical facie, hyperpigmentation, short stature, absence of pubertal development, hepatomegaly, and the presence of a splenectomy scar. Her serum ferritin level was 5190 mg/ml. Home chelation treatment with desferrioxamine was therefore commenced immediately. Subsequent evaluation identified her 2-month-old younger brother, the only son of the family, as a histocompatible marrow donor. However, her father died from liver cancer shortly after the family reunion.

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  1. Department of Paediatrics & Adolescent Medicine, Tuen Mun Hospital, New Territories, Hong Kong, China

    A C W Lee & C H Li

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  1. A C W Lee
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  2. C H Li
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Lee, A., Li, C. Child abuse: an indirect consequence of failure of bone marrow transplantation. Bone Marrow Transplant 35, 825–826 (2005). https://doi.org/10.1038/sj.bmt.1704888

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