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Fifty long-term survivors of bone marrow transplant (mean post-transplant time = 42 4 months) participated in a study examining their psychosocial adjustment and quality of life Differences between patients who received an autologous marrow transplant and those who received an allogeneic marrow transplant were identified Patients with an autologous transplant had mainly psychological difficulties in their post-transplant adaptation, whereas patients with allogeneic transplant developed more physical problems Overall, their psychosocial adjustment was similar and comparable with other medical groups of patients A quarter of both groups had failed to return to work/education and up to 9 5% had difficulty in carrying out daily tasks Twenty per cent of the patients with autologous transplant had clinical signs of anxiety and 10% clinical signs of depression, whereas there was an incidence of 10% of patients with allogeneic transplant with anxiety, but no cases with clinical depression Family relationships were found to be more integrated and lower in conflict compared with normal families Quality of life has been described as good to excellent in most of the patients Multiple regression analysis showed that physical symptomatology, vocational adjustment and depression are predictors of the degree of the patients’ quality of life