Marrow grafts from HLA-identical siblings for severe aplastic anemia: does limiting the number of transplanted marrow cells reduce the risk of chronic GvHD? Bone Marrow Transplant 2016 Dec;51(12):1573-1578
Date
08/02/2016Pubmed ID
27479689Pubmed Central ID
PMC5143192DOI
10.1038/bmt.2016.198Scopus ID
2-s2.0-84980350785 (requires institutional sign-in at Scopus site) 12 CitationsAbstract
A total of 21 patients with severe aplastic anemia (SAA) underwent marrow transplantation from HLA-identical siblings following a standard conditioning regimen with cyclophosphamide (50 mg/kg/day × 4 days) and horse antithymocyte globulin (30 mg/kg/day × 3 days). Post-grafting immunosuppression consisted of a short course of methotrexate (MTX) combined with cyclosporine (CSP). The transplant protocol tested the hypothesis that the incidence of chronic GvHD could be reduced by limiting the marrow grafts to ⩽2.5 × 108 nucleated marrow cells/kg. None of the patients rejected the graft, all had sustained engraftment and all are surviving at a median of 4 (range 1-8) years after transplantation. Chronic GvHD developed in 16% of patients given ⩽2.5 × 108 nucleated marrow cells/kg. Post-grafting immunosuppression has been discontinued in 20 of the 21 patients. In conclusion, limiting the number of transplanted marrow cells may have resulted in minimal improvement in the incidence and severity of chronic GvHD.
Author List
Gallo S, Woolfrey AE, Burroughs LM, Storer BE, Flowers ME, Hari P, Pulsipher MA, Heimfeld S, Kiem HP, Sandmaier BM, Storb RAuthor
Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Anemia, Aplastic
Bone Marrow Transplantation
Cell Count
Child
Child, Preschool
Female
Graft Survival
Graft vs Host Disease
Histocompatibility Testing
Humans
Male
Middle Aged
Siblings
Treatment Outcome
Young Adult