Marrow transplants from matched unrelated donors for aplastic anaemia using alemtuzumab, fludarabine and cyclophosphamide based conditioning
| Autor: | Judith C. W. Marsh, Sarah E. Ball, Vikas Gupta, Mylene Freires, Deborah Sage, Edward C. Gordon-Smith, Miguel Ortín |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent CD52 Cyclophosphamide Antibodies Neoplasm Graft vs Host Disease Antibodies Monoclonal Humanized Gastroenterology Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Aplastic anemia Child Alemtuzumab Bone Marrow Transplantation Immunosuppression Therapy Transplantation business.industry Histocompatibility Testing Incidence Graft Survival Bone marrow failure Anemia Aplastic Antibodies Monoclonal Hematology medicine.disease Tissue Donors Histocompatibility Fludarabine Treatment Outcome surgical procedures operative medicine.anatomical_structure Immunology Bone marrow business Vidarabine medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 35:467-471 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/sj.bmt.1704799 |
| Popis: | Graft failure, regimen-related toxicity and graft-versus-host disease (GVHD) are the critical barriers to unrelated donor transplants for aplastic anaemia (AA). We investigated the use of a novel conditioning regimen consisting of alemtuzumab (humanized CD52 antibody), fludarabine and cyclophosphamide in seven patients with AA, who underwent bone marrow transplant procedure using matched unrelated donors. The aetiology of AA was acquired (n=3), Fanconi's (n=3) and congenital (n=1). Median age was 13 years (range 8-35). All the donors were fully matched for HLA class I and II antigens using high-resolution typing. All the patients engrafted at a median of 18 days (range 13-35). Two patients died of transplant-related complications: one of adenovirus disease and the other developed extensive chronic GVHD of skin followed by cytomegalovirus (CMV) disease. Three patients developed Grade II acute GVHD disease (GVHD); none had Grade III-IV acute GVHD. Of the six evaluable patients, only one developed chronic GVHD. We conclude that this conditioning regimen for unrelated donor transplants for AA is sufficiently immunosuppressive to allow stable engraftment and appears to have a favourable impact on the incidence and severity of GVHD, warranting further investigation. |
| Databáze: | OpenAIRE |
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