Graft-versus-host disease in consecutive patients with acute myeloid leukaemia treated with blood cells from normal donors
| Autor: | Ray M. Lowenthal, D. R. Challis, C. Menon |
|---|---|
| Rok vydání: | 1981 |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion medicine.medical_treatment Gastroenterology Graft vs Host Reaction Transplantation Immunology hemic and lymphatic diseases Internal medicine Internal Medicine medicine Humans Doxorubicin Chemotherapy medicine.diagnostic_test business.industry Cytarabine Transfusion Reaction Immunosuppression Middle Aged medicine.disease Surgery Lymphoma Radiation therapy Leukemia Myeloid Acute Graft-versus-host disease business Liver function tests medicine.drug |
| Zdroj: | Australian and New Zealand journal of medicine. 11(2) |
| ISSN: | 0004-8291 |
| Popis: | Two consecutive patients with acute myeloid leukaemia (AML) developed severe probable graft-versus-host disease (GVHD) following transfusion of blood products from normal donors. In one patient the AML had arisen de novo, while in the other it occurred four years after the patient developed non-Hodgkin's lymphoma (NHL) and was treated with radiotherapy and combination cytotoxic chemotherapy. Both patients received anti-leukaemic treatment with doxorubicin and cytosine arabinoside and intensive haematological supportive care with transfusions of red cell, white cell and platelet concentrates obtained from normal donors. Clinically the GVHD in each patient was manifest by a severe erythematous rash, ifftractable diarrhoea and abnormalities in the liver function tests. On pathological examination the skin in each case showed the typical changes of GVHD. Both patients died. There have been few previous reports of GVHD occurring after accidental engraftment of immunosuppressed patients undergoing therapy for acute leukaemia. Our experience suggests that it may occur more often than has hitherto been recognised. At present there is controversy concerning the possible anti-leukaemic effects of granulocyte transfusions. Until the relative importance of the benefits and deleterious effects of cells with the potential for engraftment is determined by further studies, we recommend the routine irradiation of all cellular blood products intended for administration to acute leukaemia patients undergoing intensive cytoreductive chemotherapy. |
| Databáze: | OpenAIRE |
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