Rejection of the second allogeneic graft in a patient with severe aplastic anemia reversed by antilymphocyte globulin and donor lymphocyte infusions.
Rejection after allogeneic BMT for aplastic anemia is a complication with a high risk of mortality. We describe a patient who, following a second episode of rejection after a second BMT entered a third durable remission subsequent to treatment with ALG, donor lymphocyte infusions, GM-CSF, and erythropoietin. Therapy was well tolerated. At 5 years after rejection treatment, his hematopoiesis is of complete donor origin as determined by analyses of short tandem repeats. Thus, donor lymphocyte infusions can be considered as a therapy option for marrow rejection after allogeneic BMT for aplastic anemia.
Ljungman
P
P
Department of Medicine, Huddinge University Hospital, Karolinska Institute, Sweden.
Lawler
M
M
Lönnqvist
B
B
Ringdén
O
O
Shanwell
A
A
D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy*; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation / Q000276:immunology; D016572:Cyclosporine / Q000627:therapeutic use; D004921:Erythropoietin / Q000627:therapeutic use; D006084:Graft Rejection / Q000628:therapy*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017710:Lymphocyte Transfusion; D008297:Male; D018895:Microsatellite Repeats; D016133:Polymerase Chain Reaction; D012074:Remission Induction; D014184:Transplantation, Homologous
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D004921:Erythropoietin; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D016572:Cyclosporine