Marrow transplantation in thirty "untransfused" patients with severe aplastic anemia.
Thirty patients with severe aplastic anemia had no transfusions of blood products until just before marrow transplantation from HLA-identical family members. They were conditioned for grafting with cyclophosphamide, 50 mg/kg body weight on each of 4 successive days. All 30 had prompt initial marrow engraftment, which was sustained in 27. Twenty-five of the 30 are alive between 9 to 84 (median, 19.5) months. The actuarial projection of survival for 2 to 6 years is 75%. Twenty of the 25 surviving patients have no problems. Five have chronic graft-versus-host disease, resolving in two and active in three. Five patients died with infection or hemorrhage, four of whom had graft-versus-host disease. These data show that early transplantation should be carried out before transfusions are given for any patient with severe aplastic anemia who has an HLA-identical family member. If sensitization to minor transplantation antigens contained in blood products is avoided, the incidence of marrow-graft rejection will decrease, and survival will improve.
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000276:immunology / Q000601:surgery* / Q000628:therapy; D001853:Bone Marrow / Q000276:immunology; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006087:Graft vs Host Reaction; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D008297:Male; D010641:Phenotype; D018805:Sepsis / Q000209:etiology; D065227:Transfusion Reaction; D014184:Transplantation, Homologous
D006680:HLA Antigens