Bone marrow transplantation for severe aplastic anemia—A study of twenty-one chinese patients in Taiwan

Cheng Hwai Tzeng, Ruey Kuen Hsieh, Sheng Fan, Jin Hwang Liu, Jacqueline M. Liu, Chia Jui Liu, Kuang Yao Chen, Chien Hui Yung, Sheng Yuan Wang, Soo Ray Wang, Tzeon Jye Chiou, Po Min Chen

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

A total of 21 multiply transfused patients with severe aplastic anemia (SAA) were treated with bone marrow transplantation between March 1985 and September 1990: 20 allogeneic and one syngeneic transplants. A positive response in mixed lymphocyte culture (MLC) was also noted in 7 allogeneic recipients. Pregraft conditioning included high-dose cyclophosphamide (CY) 200 mg/kg over 4 consecutive days, followed by 300 cGy total-body irradiation the day before BMT. Seventeen patients older than 14 years received additional donor buffy-coat cells infusion for 5 days posttrans-plant. A combination of methotrexate and cyclosporine was used for prophylaxis of graft-versus-host disease. Seventeen patients were alive with a functional graft, and Kaplan-Meier product limit estimates showed a 80.95% probability of survival at 67.7 months. There were 4 deaths: two died of primary graft failure, one from secondary rejection, and the other from chronic GVHD-related complications. Acute GVHD, grade I was noted in only one patient (5.6%). In contrast, chronic GVHD was observed in 10 out of 18 (55.6%) evaluable patients. Venoocclusive liver disease and interstitial pneumonitis were not diagnosed. Our findings indicate that the combination of CY/TBI/BC is well tolerated and results in a low incidence of graft failure/rejection in multiply transfused Chinese patients who received transplants for SAA. The MTX/CsA combination was confirmed as being remarkable in reducing the incidence and severity of acute GVHD. For patients with SAA under the age of 40, with an HLA-identical sibling, we highly recommend BMT as the treatment of choice.

Original languageEnglish
Pages (from-to)569-574
Number of pages6
JournalTransplantation
Volume53
Issue number3
DOIs
Publication statusPublished - Mar 1992
Externally publishedYes

ASJC Scopus subject areas

  • Transplantation

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