Successful use of multiagent immunosuppression in the bone marrow transplantation of sensitized patients. Blood 1978 Dec;52(6):1163-9
Date
12/01/1978Pubmed ID
363204Scopus ID
2-s2.0-0018165366 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
Of 23 patients with severe aplastic anemia, 17 were sensitized to histocompatibility antigens of HLA-A, -B, and -D loci-identical potential sibling donors as determined by cell-mediated lysis (CML) assays in vitro. Antibody-dependent sensitization was detected in 3 patients, antibody-independent cellular sensitization in 11, and both in 3. Fourteen sensitized patients were transplanted after initial multiagent immunosuppression consisting of rabbit anti-human thymocyte serum, procarbazine, and cyclophosphamide, eleven with a CML-positive donor and three with a CML-negative donor. Engraftment was achieved in each of 13 patients who were evaluable, and only 2 ultimately rejected their marrow grafts, 1 with subsequent return of his own marrow function. Five patients without evidence in vitro of sensitization were transplanted after immunosuppression with cyclophosphamide alone; none of these rejected their grafts. These studies show that sensitized bone marrow transplant recipients can be successfully transplanted after optimal donor selection and multiagent immunosuppression.
Author List
Parkman R, Rappeport J, Camitta B, Levey RH, Nathan DGMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Anemia, Aplastic
Antibody-Dependent Cell Cytotoxicity
Antilymphocyte Serum
Bone Marrow Transplantation
Child
Child, Preschool
Cytotoxicity, Immunologic
Female
Graft Rejection
Humans
Immunity, Cellular
Major Histocompatibility Complex
Male
Transplantation, Homologous
