Graft failure following bone marrow transplantation for severe aplastic anemia: risk factors and treatment results.

Abstract:

: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.

journal_name

Blood

journal_title

Blood

authors

Champlin RE,Horowitz MM,van Bekkum DW,Camitta BM,Elfenbein GE,Gale RP,Gluckman E,Good RA,Rimm AA,Rozman C

subject

Has Abstract,Author List Incomplete

pub_date

1989-02-01 00:00:00

pages

606-13

issue

2

eissn

0006-4971

issn

1528-0020

journal_volume

73

pub_type

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