Bone marrow transplantation for severe aplastic anemia--a study of twenty-one Chinese patients in Taiwan
| Autor: | Sheng Fan, Soo Ray Wang, Po Min Chen, Kuang Yao Chen, Chia Jui Liu, Jacqueline M. Liu, Chien Hui Yung, Jin Hwang Liu, Ruey Kuen Hsieh, Sheng Yuan Wang, Tzeon Jye Chiou, Cheng Hwai Tzeng |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Adult
Male Resuscitation medicine.medical_specialty China Cyclophosphamide Bone marrow transplantation Adolescent Anemia Taiwan Graft vs Host Disease medicine Humans Child Bone Marrow Transplantation Transplantation business.industry Incidence (epidemiology) Graft Survival Anemia Aplastic medicine.disease Severe Aplastic Anemia Surgery surgical procedures operative medicine.anatomical_structure Child Preschool Methotrexate Female Bone marrow business medicine.drug |
| Zdroj: | Transplantation. 53(3) |
| ISSN: | 0041-1337 |
| Popis: | A total of 21 multiply transfused patients with severe aplastic anemia (SAA) were treated with bone marrow transplantation between March 1985 and September 1990: 20 allogeneic and one syngeneic transplants. A positive response in mixed lymphocyte culture (MLC) was also noted in 7 allogeneic recipients. Pregraft conditioning included high-dose cyclophosphamide (CY) 200 mg/kg over 4 consecutive days, followed by 300 cGy total-body irradiation the day before BMT. Seventeen patients older than 14 years received additional donor buffy-coat cells infusion for 5 days posttransplant. A combination of methotrexate and cyclosporine was used for prophylaxis of graft-versus-host disease. Seventeen patients were alive with a functional graft, and Kaplan-Meier product limit estimates showed a 80.95% probability of survival at 67.7 months. There were 4 deaths: two died of primary graft failure, one from secondary rejection, and the other from chronic GVHD-related complications. Acute GVHD, grade I was noted in only one patient (5.6%). In contrast, chronic GVHD was observed in 10 out of 18 (55.6%) evaluable patients. Venoocclusive liver disease and interstitial pneumonitis were not diagnosed. Our findings indicate that the combination of CY/TBI/BC is well tolerated and results in a low incidence of graft failure/rejection in multiply transfused Chinese patients who received transplants for SAA. The MTX/CsA combination was confirmed as being remarkable in reducing the incidence and severity of acute GVHD. For patients with SAA under the age of 40, with an HLA-identical sibling, we highly recommend BMT as the treatment of choice. |
| Databáze: | OpenAIRE |
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