Graft failure following bone marrow transplantation for severe aplastic anemia: risk factors and treatment results. Blood 1989 Feb;73(2):606-13
Date
02/01/1989Pubmed ID
2644980DOI
10.1182/blood.v73.2.606.bloodjournal732606Scopus ID
2-s2.0-0024592842 (requires institutional sign-in at Scopus site) 285 CitationsAbstract
Graft failure was analyzed in 625 patients receiving allogeneic bone marrow transplants from HLA-identical sibling donors as treatment for severe aplastic anemia. Sixty-eight (11%) had no or only transient engraftment. Second bone marrow transplants were successful in achieving extended survival in 16 of 27 patients with transient initial engraftment but in none of ten patients with no sign of engraftment after the first transplant. The major factors associated with a reduced risk of graft failure were use of radiation for pretransplant immunosuppression and use of cyclosporine rather than methotrexate or T-cell depletion of the donor bone marrow for prophylaxis against graft-v-host disease (GVHD). Among 266 patients prepared for transplantation with cyclophosphamide alone, the risk of graft failure was increased in patients who received previous transfusions and reduced in those who received corticosteroids for previous therapy. Neither cell dose nor administration of donor buffy coat cells affected the probability of engraftment. Although use of radiation in conditioning reduced graft failure, survival was not improved. Posttransplant treatment with cyclosporine and avoidance of pretransplant blood transfusions were associated with improved survival.
Author List
Champlin RE, Horowitz MM, van Bekkum DW, Camitta BM, Elfenbein GE, Gale RP, Gluckman E, Good RA, Rimm AA, Rozman CAuthor
Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Actuarial AnalysisAdolescent
Adult
Anemia, Aplastic
Bone Marrow Transplantation
Child
Child, Preschool
Cyclophosphamide
Female
Graft Rejection
Graft vs Host Disease
Humans
Immunosuppressive Agents
Infant
Male
Middle Aged
Premedication
Risk Factors
Twins, Monozygotic
