title: Late marrow allograft rejection following alpha-interferon therapy for hepatitis in a patient with paroxysmal nocturnal hemoglobinuria.
abstract: We describe a case of allograft rejection that occurred 23 months after successful bone marrow transplantation for severe aplastic anemia in a patient with paroxysmal nocturnal hemoglobinuria. The allograft rejection appears to have been induced by recombinant alpha-interferon (rINF-alpha) treatment for non-A, non-B hepatitis that developed 11 months after transplantation. During the 9 months of active hepatitis, the donor graft functioned normally; however, 3 months after rINF-alpha therapy was started, pancytopenia and a chimeric hematopoietic state developed. rINF-alpha was discontinued, cyclosporin A was reintroduced, and autologous bone marrow recovery followed. rINF-alpha treatment may be detrimental to some recipients of allogeneic bone marrow transplants.
authors.affiliation: Centro National de Transplante de Medula Ossea, Instituto Nacional do Cancer, Rio de Janeiro, Brazil.
authors.forename: M H
authors.initials: MH
authors.lastname: de Souza
authors.forename: E
authors.initials: E
authors.lastname: Abdelhay
authors.forename: M L
authors.initials: ML
authors.lastname: Silva
authors.forename: H R
authors.initials: HR
authors.lastname: Diamond
authors.forename: A N
authors.initials: AN
authors.lastname: Valente
authors.forename: D G
authors.initials: DG
authors.lastname: Tabak
authors.forename: L F
authors.initials: LF
authors.lastname: Bouzas
authors.forename: R C
authors.initials: RC
authors.lastname: Ribeiro
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection; D006457:Hemoglobinuria, Paroxysmal / Q000628:therapy*; D006521:Hepatitis, Chronic / Q000209:etiology / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*
chemical_list: D016898:Interferon-alpha; D016572:Cyclosporine