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Marrow Transplantation in Thirty "Untransfused" Patients with Severe Aplastic Anemia

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.; and PAUL L. WEIDEN, M.D.
[+] Article and Author Information

Grant Support: CA 18029, CA 15704, CA 09319, and CA 18221, awarded by the National Cancer Institute. Dr. Thomas is a recipient of a Research Career Award AI 02425 from the National Institute of Allergy and Infectious Diseases. Dr. Deeg is a Fellow of the Leukemia Society of America. Dr. Fefer is an American Cancer Society Professor of Clinical Oncology. Dr. Sale is supported in part by a Junior Faculty Clinical Fellowship from the American Cancer Society. Dr. Stewart is supported in part by a Junior Faculty Clinical Fellowship from the American Cancer Society.

▸Requests for reprints should be addressed to Rainer Storb, M.D.; Division of Oncology, Fred Hutchinson Cancer Research Center; 1124 Columbia Street; Seattle, WA 98104.


Seattle, Washington


©1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;92(1):30-36. doi:10.7326/0003-4819-92-1-30
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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.

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