Total lymphoid irradiation, anti-lymphocyte globulin and Campath 1-G for immunosuppression prior to bone marrow transplantation for aplastic anemia after repeated graft rejection.
Allogeneic BMT for severe aplastic anemia is associated with a significant rate of graft rejection, especially in patients who have been previously transfused. We report a child with aplastic anemia who rejected donor marrow twice despite adequate immunosuppression as part of the conditioning therapy but engrafted successfully following combined administration of three modalities of immunosuppression: antithymocyte globulin, total lymphoid irradiation and the monoclonal antibody Campath-1G. Restriction fragment length polymorphism studies > 1 year after BMT show full donor hematopoiesis with no evidence of autologous recovery.
Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel.
R
R
Or
J
J
Mehta
J
J
Kapelushnik
M
M
Aker
E
E
Naparstek
A
A
Nagler
G
G
Cividalli
S
S
Slavin
D000074323:Alemtuzumab; D000741:Anemia, Aplastic / Q000139:chemically induced / Q000601:surgery*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D015703:Antigens, CD; D000951:Antigens, Neoplasm; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods*; D000074301:CD52 Antigen; D002675:Child, Preschool; D006023:Glycoproteins; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D008221:Lymphoid Tissue / Q000528:radiation effects; D008297:Male; D012086:Reoperation; D013752:Tetracycline / Q000009:adverse effects
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D015703:Antigens, CD; D000951:Antigens, Neoplasm; D000961:Antilymphocyte Serum; D000074301:CD52 Antigen; C000613862:CD52 protein, human; D006023:Glycoproteins; D000074323:Alemtuzumab; D013752:Tetracycline