Preceding immunosuppressive therapy with antithymocyte globulin and ciclosporin increases the incidence of graft rejection in children with aplastic anaemia who underwent allogeneic bone marrow transplantation from HLA-identical siblings.
The incidence of graft rejection was determined in 66 children with acquired aplastic anaemia (AA) following bone marrow transplantation (BMT) from a related donor. Eleven of 65 evaluable patients experienced either early or late rejection. Multivariate analysis identified previous immunosuppressive therapy with antithymocyte-globulin (ATG) and ciclosporin (CsA) as a risk factor for graft rejection (relative risk: 16.6, P = 0.001). Patients who received ATG and CsA had a significantly lower probability of failure-free survival than those who did not (69.7 +/- 6.2% vs. 87.9 +/- 8.0%, P = 0.044). These results suggest that BMT should be instituted immediately in children with severe AA who have human leucocyte antigen-identical siblings.
Kobayashi
Ryoji
R
Department of Paediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan. r-koba@med.hokudai.ac.jp
Yabe
Hiromasa
H
Hara
Junichi
J
Morimoto
Akira
A
Tsuchida
Masahiro
M
Mugishima
Hideo
H
Ohara
Akira
A
Tsukimoto
Ichiro
I
Kato
Koji
K
Kigasawa
Hisato
H
Tabuchi
Ken
K
Nakahata
Tatsutoshi
T
Ohga
Shoichi
S
Kojima
Seiji
S
D000293:Adolescent; D000741:Anemia, Aplastic / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012307:Risk Factors; D035781:Siblings; D018709:Statistics, Nonparametric; D015996:Survival Rate; D019172:Transplantation Conditioning; D014185:Transplantation, Isogeneic; D017211:Treatment Failure
D000961:Antilymphocyte Serum; D000970:Antineoplastic Agents; D016572:Cyclosporine