Unrelated donor marrow transplantation in children with severe aplastic anaemia using cyclophosphamide, anti‐thymocyte globulin and total body irradiation
2001; Wiley; Volume: 114; Issue: 3 Linguagem: Inglês
10.1046/j.1365-2141.2001.02992.x
ISSN1365-2141
AutoresSeiji Kojima, Jun Inaba, Ayami Yoshimi, Yoshiyuki Takahashi, Nobuhiro Watanabe, Kazuko Kudo, Keizo Horibe, Naoko Maeda, Koji Kato, Takaharu Matsuyama,
Tópico(s)T-cell and B-cell Immunology
ResumoWe report a favourable outcome in 15 patients with severe aplastic anaemia (SAA) who were < 20 years of age and who underwent bone marrow transplantation (BMT) from a human leucocyte antigen (HLA)‐matched unrelated donor. All patients were non‐responders to intensive immunosuppressive therapy (IST) and were multiply transfused. The conditioning regimen consisted of cyclophosphamide (60 mg/kg/d, on d −4 and −3), anti‐thymocyte globulin (2·5 mg/kg/d, on d −5 to −2) and total body irradiation (2·5 Gy × 2/d, on d −2 and −1). Patients received cyclosporine and methotrexate for prophylaxis of graft‐versus‐host disease (GVHD), except for the last four who received tacrolimus instead of cyclosporine. Donor/recipient pairs were identical for HLA class I and II antigens by serological typing, but four pairs were found to have a mismatch at the HLA‐A, ‐B or ‐DRB1 locus by high‐resolution typing. All patients achieved rapid engraftment and are alive at 2–86 months after transplantation (median follow‐up, 51 months). Moderate to severe acute GVHD occurred in 5 out of 15 patients (33%); only one patient developed extensive chronic GVHD. Considering our encouraging results, unrelated donor transplantation for SAA is recommended as a salvage therapy in non‐responders to IST.
Referência(s)