Successful bone marrow transplantation in sensitized aplastic anemia patients using total lymphoid irradiation for conditioning: long-term follow-up
✍ Scribed by Almudena Zapatero; Alicia Marín; Mario López; Carmen Martín De Vidales; Laura Cerezo; Pedro Domínguez; Armando Pérez Torrubia
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 520 KB
- Volume
- 14
- Category
- Article
- ISSN
- 0278-0232
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✦ Synopsis
Between June 1986 and November 1994, 22 previously transfused patients with severe aplastic anemia (SAA) were treated with high-dose cyclophosphamide (CY) (50 mglkg over 4 consecutive days) and 7 Gy total lymphoid irradiation (TLI) in two fractions before allogeneic bone marrow transplantation (BMT) from HLA-identical sibling. Graft-versus-host-disease (GVHD) prophylaxis included the combination of methotrexate and cyclosporine A in all cases. Actuarial survival at 5 years is 73 f 9 per cent for the entire group and 86 f I3 per cent for the seven patients < 18 years. The incidence of graft failure was 0 per cent, and of acute GVHD and chronic GVHD was 31.5 per cent and 24 per cent respectively. Prolonged interval from diagnosis to BMT adversely influenced survival (P=0.03). No hypothyroidism or secondary malignancies have been documented in this series. Our findings indicate that survival with CY-TLI is comparable to that obtained using preparative regimens without radiation. The changing role of radiotherapy in pretransplant immunosuppression for SAA is discussed. c) 1996 by John Wiley & Sons.
Ltd.