RAINER STORB, M.D.; E. DONNALL THOMAS, M.D.; C. DEAN BUCKNER, M.D.; REGINALD A. CLIFT, F.I.M.L.S.; H. JOACHIM DEEG, M.D.; ALEXANDER FEFER, M.D.; BRIAN W. GOODELL, M.D.; GEORGE E. SALE, M.D.; JEAN E. SANDERS, M.D.; JACK SINGER, M.D.; PATRICIA STEWART, M.D.; PAUL L. WEIDEN, M.D.
Thirty patients with severe aplastic anemia had no transfusions of blood products until just before marrow transplantation from HLA-identical family members. They were conditioned for grafting with cyclophosphamide, 50 mg/kg body weight on each of 4 successive days. All 30 had prompt initial marrow engraftment, which was sustained in 27. Twenty-five of the 30 are alive between 9 to 84 (median, 19.5) months. The actuarial projection of survival for 2 to 6 years is 75%. Twenty of the 25 surviving patients have no problems. Five have chronic graft-versus-host disease, resolving in two and active in three. Five patients died with infection or hemorrhage, four of whom had graft-versus-host disease. These data show that early transplantation should be carried out before transfusions are given for any patient with severe aplastic anemia who has an HLA-identical family member. If sensitization to minor transplantation antigens contained in blood products is avoided, the incidence of marrow-graft rejection will decrease, and survival will improve.
STORB R, THOMAS ED, BUCKNER CD, CLIFT RA, DEEG HJ, FEFER A, et al. Marrow Transplantation in Thirty "Untransfused" Patients with Severe Aplastic Anemia. Ann Intern Med. 1980;92:30–36. doi: 10.7326/0003-4819-92-1-30
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Published: Ann Intern Med. 1980;92(1):30-36.
Hematology/Oncology, Red Cell Disorders.
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