title: Bone marrow transplantation in children with severe aplastic anemia using a conditioning regimen containing 3 Gy of total body irradiation, cyclophosphamide with or without antithymocyte globulin.
abstract: We have employed the 3 Gy total body irradiation (TBI) containing conditioning regimen to bone marrow transplantation (BMT) for severe aplastic anemia (SAA) in pediatric patients irrespective of donor type since March 1986. The outcome of BMT for 17 SAA patients is favorable. Eight patients received BMT from human leukocyte antigen matched-related donors (MRD) and nine received BMT from alternative donors. The conditioning regimen consisted of 3-Gy TBI and cyclophosphamide of 200 mg/kg in the BMT from MRD. In the case of BMT from alternative donor, antithymocyte globulin 10 mg/kg was added to the regimen. Fifteen of 17 patients (88%) engrafted on median of day 18 (range, 11-26) and all 13 evaluable patients showed complete donor chimerism by median 30 (range, 13-47) days after BMT. Fourteen patients have survived with a median follow-up of 67 (range, 2-228) months and the probability of survival was 81.9% (95% CI, 63.3-100%). No late complications including second malignancies caused by TBI have been observed and all three female patients have regular menstruation. In conclusion, TBI of 3 Gy appears to be an appropriate dose regarding to ensure engraftment and avoid the risk of late adverse event for SAA patients.
authors.affiliation: Section of Pediatrics, National Kyusyu Cancer Center, Notame, Fukuoka, Japan. inagakij@nk-cc.go.jp
authors.forename: Jiro
authors.initials: J
authors.lastname: Inagaki
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nagatoshi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawano
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Saito
authors.forename: Daijiro
authors.initials: D
authors.lastname: Takahashi
authors.forename: Jun
authors.initials: J
authors.lastname: Nagayama
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shinkoda
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirata
authors.forename: Jun
authors.initials: J
authors.lastname: Okamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000601:surgery*; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D011879:Radiotherapy Dosage; D019172:Transplantation Conditioning
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide