Successful use of multiagent immunosuppression in the bone marrow transplantation of sensitized patients

Autor: Joel M. Rappeport, David G. Nathan, Bruce M. Camitta, Raphael H. Levey, Robertson Parkman
Rok vydání: 1978
Předmět:
Zdroj: Blood. 52:1163-1169
ISSN: 1528-0020
0006-4971
DOI: 10.1182/blood.v52.6.1163.1163
Popis: Of 23 patients with severe aplastic anemia, 17 were sensitized to histocompatibility antigens of HLA-A, -B, and -D loci-identical potential sibling donors as determined by cell-mediated lysis (CML) assays in vitro. Antibody-dependent sensitization was detected in 3 patients, antibody-independent cellular sensitization in 11, and both in 3. Fourteen sensitized patients were transplanted after initial multiagent immunosuppression consisting of rabbit anti-human thymocyte serum, procarbazine, and cyclophosphamide, eleven with a CML-positive donor and three with a CML-negative donor. Engraftment was achieved in each of 13 patients who were evaluable, and only 2 ultimately rejected their marrow grafts, 1 with subsequent return of his own marrow function. Five patients without evidence in vitro of sensitization were transplanted after immunosuppression with cyclophosphamide alone; none of these rejected their grafts. These studies show that sensitized bone marrow transplant recipients can be successfully transplanted after optimal donor selection and multiagent immunosuppression.
Databáze: OpenAIRE