Late marrow allograft rejection following alpha-interferon therapy for hepatitis in a patient with paroxysmal nocturnal hemoglobinuria.
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.
de Souza
M H
MH
Centro National de Transplante de Medula Ossea, Instituto Nacional do Cancer, Rio de Janeiro, Brazil.
Abdelhay
E
E
Silva
M L
ML
Diamond
H R
HR
Valente
A N
AN
Tabak
D G
DG
Bouzas
L F
LF
Ribeiro
R C
RC
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*
D016898:Interferon-alpha; D016572:Cyclosporine