Unrelated donor bone marrow transplantation to treat severe aplastic anaemia in children and young adults
| Autor: | Karen Pierce, Bruce M. Camitta, James T. Casper, LA Baxter-Lowe, Mary Jo Kupst, Carolyn A. Keever-Taylor, D Pietryga, Kevin Murray, Colleen Lawton, Robert L. Truitt, Frederick Garbrecht, David A. Margolis, James French, Neal Flomenberg |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Graft vs Host Disease Gastroenterology Internal medicine Immunopathology medicine Humans Aplastic anemia Young adult Child Bone Marrow Transplantation business.industry Graft Survival Anemia Aplastic Infant Immunosuppression Hematology Total body irradiation medicine.disease Survival Analysis Histocompatibility Surgery surgical procedures operative Treatment Outcome Child Preschool Chemoprophylaxis Female Complication business Follow-Up Studies |
| Zdroj: | British journal of haematology. 94(1) |
| ISSN: | 0007-1048 |
| Popis: | Alternative donor bone marrow transplantation (BMT) to treat severe aplastic anaemia (SAA) in children and young adults has been complicated by high rates of graft rejection and severe graft-versus-host disease (GVHD). We hypothesized that increased immunosuppression combined with T-cell depletion of the marrow graft would enable successful use of unrelated donor BMT in this disease. Preconditioning consisted of cytosine arabinoside, cyclophosphamide, and total body irradiation (TBI). T-cell depletion was with the anti-CD3 antibody T10B9. GVHD prophylaxis consisted of cyclosporine A. 28 previously transfused patients were transplanted. Nine donor/recipient pairs were HLA matched. As of 1 January 1996, 15/28 (54%) patients are alive, transfusion independent and well with a range of follow-up of 13 months to 8 years (median 2.75 years). Fatalities include all three patients with nonengraftment and all three patients with grade III/IV GVHD. Other fatalities were due to infections or therapy-related toxicity. The incidenceor= grade II acute GVHD was 28%. These data show that in children with SAA who have failed immunosuppression, unrelated donor BMT offers a reasonable hope of long-term survival. |
| Databáze: | OpenAIRE |
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