Abstract:
BACKGROUND:Bone marrow transplantation (BMT) for class 3 patients with thalassemia is challenging due to high rates of graft rejection and transplant-related mortality. Since the first studies of BMT in the late 1980s, a number of conditioning regimens have been designed to improve outcomes, but with suboptimal results. Here we report the outcome of transplantation in class 3 patients using a modified protocol. METHODS:Sixty-three patients between 5 and 16.7 years of age with class 3 thalassemia received HLA-matched sibling BMT following either the original protocol (26 patients) or the modified protocol (37 patients). Both regimens comprised preconditioning cytoreduction with hydroxyurea and azathioprine starting at -45 days pretransplant, and fludarabine from days -16 to -12. Conditioning was performed with busulfan and cyclophosphamide (original protocol) or with busulfan, thiotepa, and cyclophosphamide (modified protocol). RESULTS:The 2 groups showed similar patient demographics. At day 0, the degree of cytoreduction (lymphopenia, neuthropenia, and thrombocytopenia) achieved by the modified protocol was greater than the original protocol. The incidence of graft failure/rejection was significantly higher in the original group (15%; 95% confidence interval [95% CI], 5-32%) compared with the modified group (0%) (P = 0.014). The respective 5-year thalassemia-free survival rates were 73% (95% CI, 51-86%) and 92% (95% CI, 77-97%) (P = 0.047). Both groups showed similar incidences of grades II to IV acute graft-versus host disease. Modified protocol did not increase nonhematological toxicity or infectious complications. CONCLUSIONS:The modified treatment protocol effectively and safely prevented graft failure/rejection and significantly increased thalassemia-free survival of class 3 patients with thalassemia.
journal_name
Transplantationjournal_title
Transplantationauthors
Gaziev J,Isgrò A,Sodani P,Marziali M,Paciaroni K,Gallucci C,De Angelis G,Andreani M,Testi M,Alfieri C,Ribersani M,Galluccio T,Battarra MR,Morrone A,Lucarelli Gdoi
10.1097/TP.0000000000000928subject
Has Abstractpub_date
2016-04-01 00:00:00pages
925-32issue
4eissn
0041-1337issn
1534-6080journal_volume
100pub_type
杂志文章相关文献
TRANSPLANTATION文献大全abstract:BACKGROUND:The present study was undertaken to determine whether anti-complement 5 (C5) monoclonal antibodies (mAb) prevent hyperacute rejection (HAR) in a rat-to-presensitized mouse heart transplantation model and whether these mAb, combined with cyclosporine (CsA) and cyclophosphamide (CyP), can achieve long-term gra...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199912150-00007
更新日期:1999-12-15 00:00:00
abstract::The protective effect of oxygen free radical scavenger superoxide dismutase (SOD) against the warm ischemic damage that occurs in kidneys harvested from non-heart-beating donors is controversial because of its short half-life. In this model, we compared the protective effect of SOD and two longer lasting polyethylene ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199611150-00006
更新日期:1996-11-15 00:00:00
abstract:BACKGROUND:Graft arterial disease (GAD) is a major cause of late graft loss after organ transplantation. Alloimmune responses and vascular remodeling eventually cause the transplant organ to develop GAD. In this study, we aimed to limit the development of GAD by inhibiting alloimmune responses and vascular smooth muscl...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000000576
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Tacrolimus (Tac) has immunosuppressant properties similar to those of cyclosporine A (CsA), but it is more potent. At present, however, its immunosuppressive activity in renal transplant recipients with ongoing chronic rejection has not been clarified. METHODS:We studied changes in kidney function, mixed ly...
journal_title:Transplantation
pub_type: 临床试验,杂志文章
doi:10.1097/01.tp.0000112438.46472.38
更新日期:2004-02-27 00:00:00
abstract:BACKGROUND:The management of ureteral strictures in transplanted kidney is challenging. Open surgical treatment is effective but entails significant convalescence. Holmium:yttrium-aluminum-garnet (Ho:YAG) laser endoureterotomy is useful for other types of ureteral obstruction, and we aimed to assess its long-term succe...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e31816c7f19
更新日期:2008-05-15 00:00:00
abstract:BACKGROUND:We have previously shown that recognition of human erythrocytes by porcine Kupffer cells is mediated by a carbohydrate-dependent mechanism. The present study explores the possible ligands existing on human glycophorin A and tests their ability to inhibit erythrocyte rosette formation. METHODS:Human erythroc...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000162974.94890.9f
更新日期:2005-08-15 00:00:00
abstract::Studies on liver interstitial dendritic cells (DC) indicate that the maturation and function of these important antigen-presenting cells may be suppressed by continual exposure to microbial products from the gut, in particular, bacterial lipopolysaccharide. New evidence is emerging for a role of specific intracellular...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/TP.0b013e3181af7c0d
更新日期:2009-08-15 00:00:00
abstract::Transplant coronary artery disease and malignancy are the major limitations to survival after heart transplantation. In a randomized trial, mycophenolate mofetil (MMF) significantly improved 3-year survival over azathioprine, but the expected reduction in intracoronary ultrasound evidence of vasculopathy was not found...
journal_title:Transplantation
pub_type: 杂志文章,评审
doi:10.1097/01.tp.0000153302.27299.16
更新日期:2005-02-15 00:00:00
abstract::Single lung isografting in rats with pulmonary hypertension has been reported. However, it is hard to evaluate cardiopulmonary hemodynamics accurately or to use circulatory assists during procedures using rats. Therefore, we tried to establish a model of pulmonary hypertension in the beagle. Twenty young beagles were ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199507150-00002
更新日期:1995-07-15 00:00:00
abstract:BACKGROUND:The authors investigated the cognitive status during the late postoperative phase in children who had undergone liver transplantation (LTx). METHODS:The authors examined 44 children who had undergone liver transplantation at their center. The children were 8.9+/-2.3 (mean+/-SD) years of age and had received...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000161251.20520.42
更新日期:2005-05-15 00:00:00
abstract::Donor pancreas utilization rates for whole organ transplant have remained low and have decreased over time. To identify the reasons for nonuse of pancreas from donors who meet common baseline acceptance criteria, we examined Organ Procurement and Transplantation Network data from 2005 to 2007 and identified a subgroup...
journal_title:Transplantation
pub_type: 社论,评审
doi:10.1097/TP.0b013e3181e9fea4
更新日期:2010-09-15 00:00:00
abstract:BACKGROUND:The beneficial effects of glycemic control on both survival and function of transplanted kidneys in patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease (ESRD) have been recognized. METHODS:Herein, we present the clinical outcome of a single-center pilot trial of islet after kidney (IAK...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e318166a27b
更新日期:2008-03-27 00:00:00
abstract:BACKGROUND:HLAMatchmaker is a computer algorithm that determines human leukocyte antigen (HLA) compatibility at the level of polymorphic amino acid triplets in antibody-accessible sequence positions. Recent studies have shown that HLA-DR-matched kidney transplant recipients with zero to two triplet mismatches had almos...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.TP.0000055097.58209.83
更新日期:2003-03-27 00:00:00
abstract:BACKGROUND:The role of natural killer (NK) cells and macrophages (Møs) in the absence of T cell immunity in discordant xenograft (xg) rejection was investigated. METHODS:Guinea pig hearts were transplanted into athymic nude rats receiving no treatment or antixenoantibody (xAb), anticomplement (C), antinatural killer (...
journal_title:Transplantation
pub_type: 杂志文章
doi:
更新日期:2000-07-15 00:00:00
abstract:BACKGROUND:Endothelial dysfunction (ED) has a major role in the cardiovascular outcome of patients with chronic kidney disease (CKD). The aim of this study was to investigate the relation between fetuin A levels and ED in kidney transplant recipients. METHODS:Forty-two living donor kidney transplant recipients, 21 (11...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000251647.72673.c7
更新日期:2007-02-27 00:00:00
abstract::Nonmajor histocompatibility complex (non-MHC) antigens are important targets of graft rejection and graft-versus-host disease in clinical transplantation. Little is known regarding immunity to non-MHC antigens. To study this problem we evaluated the effect of antihuman thymocyte globulin (ATG) on reactivity in autolog...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-198102000-00001
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:The administration of systemic immunosuppressive agents to recipients of solid organ or bone marrow transplants results in an immunocompromised status. As the number of organ recipients and their life span increase with recent progress in organ transplantation, ocular complications tend to become more divers...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000259386.59375.8a
更新日期:2007-03-27 00:00:00
abstract:BACKGROUND:Deep venous thrombosis (DVT) is a common problem with potentially devastating results in patients undergoing major surgical procedures. Certain renal transplant recipients are particularly at risk for allograft loss as a consequence of renal vein and artery thrombosis. Over the past few years, low molecular ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199808270-00020
更新日期:1998-08-27 00:00:00
abstract::Immunosuppression with sirolimus and low-dose tacrolimus has facilitated successful clinical islet transplantation (CIT). Because the long-term effects on the kidney are unknown and immunosuppressant drugs can be nephrotoxic, CIT is currently restricted to patients with preserved renal function or a functioning renal ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000134971.15093.07
更新日期:2004-09-27 00:00:00
abstract::Hematopoietic growth factors (HGF) mobilize potential tolerogenic cells in transplant donors. Fms-like tyrosine kinase 3 ligand (Flt3L) mobilizes stem cells and dendritic cells (DCs) in human and nonhuman primate blood. Blood and renal and liver biopsies were obtained from untreated and Flt3L-mobilized rhesus macaques...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000255320.00061.e9
更新日期:2007-03-15 00:00:00
abstract::To determine the impact of different flush and reperfusion techniques on postreperfusion syndrome (PRS) and postoperative graft function, 100 transplants were randomly assigned into four groups as follows: group 1 (n=31), portal vein flush, no vena caval venting; group 2 (n=21), hepatic arterial flush, no vena caval v...
journal_title:Transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007890-199702150-00012
更新日期:1997-02-15 00:00:00
abstract:BACKGROUND:The piggyback technique of orthotopic liver transplantation is an attractive alternative that preserves the recipient inferior vena cava and allows uninterrupted venous blood return during the anhepatic phase. As with other transplantation techniques, the vascular anastomoses required by the piggyback techni...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199908150-00018
更新日期:1999-08-15 00:00:00
abstract:INTRODUCTION:Cytomegalovirus infection after heart transplantation is considered as risk factor for the development of transplant arteriosclerosis. Therefore, the aim of this study was to investigate the effect of murine cytomegalovirus (MCMV) as a single risk factor on transplant arteriosclerosis in an experimental ao...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181e8a699
更新日期:2010-08-27 00:00:00
abstract:BACKGROUND:Endomyocardial biopsy (EMB) remains the gold standard for acute cellular rejection (ACR) diagnosis in cardiac transplantation yet is subject to interobserver variability. A method that could avoid discordant EMB analysis would be desirable. The apoptosis rate in EMB correlates with ACR severity. Apollon inhi...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3181c3c690
更新日期:2010-01-27 00:00:00
abstract:BACKGROUND:We recently demonstrated that inhibition of inducible nitric oxide synthase (iNOS) ameliorated severe acute lung allograft rejection. This study used a rat lung transplant model to determine (1) the time course and cellular localization of iNOS expression during the histological progression of unmodified acu...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199704270-00008
更新日期:1997-04-27 00:00:00
abstract:BACKGROUND:The role of asymptomatic bacteriuria in kidney transplant recipients is unknown. There is no clear evidence of its effect on transplanted kidney. METHODS:We studied urine cytokines profile among kidney transplant recipients with bacteriuria found in screening examination. Urine cultures were collected in 26...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/01.tp.0000226072.20185.f8
更新日期:2006-06-27 00:00:00
abstract::India with a population of 1.2 billion has a renal transplantation rate of 3.25 per million population. The major cause of chronic kidney disease is hypertension and diabetes. The crude and age-adjusted incidence rates of end-stage renal disease are estimated to be 151 and 232 per million population, respectively, in ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0b013e3182469b91
更新日期:2012-04-27 00:00:00
abstract:BACKGROUND:Immunogenicity of a graft depends on its expression of major histocompatability complex (MHC) antigens and adhesion molecules and on the amount of intragraft leukocytes, the so-called passenger leukocytes. Although long-term culture reduces passenger leukocytes, permanent acceptance is not necessarily observ...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-200208270-00003
更新日期:2002-08-27 00:00:00
abstract:BACKGROUND:It is unclear if the category of acute rejection with intimal arteritis (ARV) is relevant to short- and long-term clinical outcomes and if the graft outcomes are affected by the severity of intimal arteritis. METHODS:One hundred forty-eight ARV episodes were reviewed and categorized according to the 2013 Ba...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/TP.0000000000000640
更新日期:2015-08-01 00:00:00
abstract::Cyclosporine (CsA) administration and nitric oxide (NO) blockade promote similar chronic renal hemodynamic alterations in rats. We evaluated various clinical CsA doses under conditions of NO blockade using L-NAME (N-nitro L-arginine methyl ester). Groups of Sprague-Dawley rats kept on a normal salt (+NaCl) or low-salt...
journal_title:Transplantation
pub_type: 杂志文章
doi:10.1097/00007890-199605270-00017
更新日期:1996-05-27 00:00:00