Successful Correction of Hemophagocytic Lymphohistiocytosis With Related or Unrelated Bone Marrow Transplantation
| Autor: | Michael Steinbuch, Thomas G. Gross, Alexandra H. Filipovich, R. S. Shapiro, Cynthia A. DeLaat, Brett Loechelt, K. Scott Baker, Richard E. Harris |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Hemophagocytic lymphohistiocytosis Cyclophosphamide business.industry Immunology Cell Biology Hematology medicine.disease Biochemistry Gastroenterology Surgery Transplantation surgical procedures operative medicine.anatomical_structure Internal medicine medicine Bone marrow Transplantation Conditioning business Etoposide Busulfan medicine.drug Preparative Regimen |
| Zdroj: | Blood. 89:3857-3863 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood.v89.10.3857.3857_3857_3863 |
| Popis: | Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder of immune regulation leading to widespread lymphocytic and hemophagocytic infiltration of vital organs. Apparent cure has only been achieved with allogeneic bone marrow transplantation (BMT). This report describes 20 consecutive patients, who underwent either matched sibling donor (n = 4) or unrelated donor (URD; n = 16) BMT. Age at the time of BMT was 0.4 to 5.3 years (median, 0.8 years). Central nervous system disease was present at diagnosis in 13 patients. At BMT, 14 patients were in a clinical remission, whereas 6 patients had active HLH. All patients were engrafted after cytoreduction with busulfan, cyclophosphamide, and etoposide. The probability of grade II-III acute graft-versus-host disease (GVHD) for all patients was 57% (95% confidence limit [CL], 0.28, 0.86), and 73% (95% CL, 0.44, 1.0) in URD patients. The overall probability of survival at 3 years was 45% (95% CL, 0.23, 0.67) and 44% (95% CL, 0.19, 0.68) when URD BMT was evaluated separately. Favorable BMT outcome was associated with clinical remission status at the time of BMT. The preparative regimen was well tolerated, and in the 9 surviving patients it provided durable engraftment and was effective at eradicating the underlying disease. |
| Databáze: | OpenAIRE |
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