TRANSPLANTATION OF THE BONE MARROW FROM A HLA-COMPATIBLE UNRELATED DONOR AFTER IMMUNOABLATIVE CONDITIONING IN CHILDREN WITH ACQUIRED APLASTIC ANEMIA UNRESPONSIVE TO COMBINED IMMUNOSUPPRESSIVE THERAPY: PRELIMINARY RESULTS

被引：0

作者：

Novichkova, G. A. ^{[1
]}

Maschan, M. A. ^{[1
]}

Shipitsyna, I. P. ^{[2
]}

Skvortsova, Yu. V. ^{[2
]}

Persiantseva, M. I. ^{[1
]}

Lebedeva, L. L.

Bobrynina, V. O. ^{[1
]}

Baidildina, D. D. ^{[2
]}

Goronkova, O. V. ^{[2
]}

Solopova, G. G. ^{[2
]}

Khachatryan, L. A. ^{[1
]}

Petrova, U. N. ^{[1
]}

Suntsova, E. V. ^{[2
]}

Kalinina, I. I. ^{[1
]}

Sinitsyna, V. V. ^{[1
]}

Skorobogatova, E. V. ^{[2
]}

Balashov, D. N. ^{[1
,2
]}

Dyshlevaya, Z. M. ^{[2
]}

Shelikhova, L. N. ^{[2
]}

Kurnikova, E. E. ^{[2
]}

Trakhtman, P. E. ^{[2
]}

Maschan, A. A. ^{[1
]}

机构：

[1] Minist Hlth Russian Federat, Fed Res & Clin Ctr Pediat Hematol Oncol & Immunol, Moscow, Russia

[2] Russian Childrens Hosp, Moscow, Russia

来源：

TERAPEVTICHESKII ARKHIV | 2010年 / 82卷 / 07期

关键词：

children; acquired aplastic anemia; transplantation; unrelated donors; tacrolimus; thoracoabdominal irradiation; ANTI-THYMOCYTE GLOBULIN; COLONY-STIMULATING FACTOR; ANTITHYMOCYTE GLOBULIN; ALTERNATIVE DONOR; CYCLOPHOSPHAMIDE; CYCLOSPORINE; DISEASE; GRAFT; RISK;

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aim. To analyze the efficiency of transplantation of the bone marrow from a HLA-compatible unrelated donor and continued immunosuppressive therapy (IST) in children with aplastic anemia (AA) unresponsive to 2 courses of IST. Subjects and methods. The study enrolled 14 children aged 2-16 years (median 9 years). A control group comprised 26 patients in whom IST was continued. The median interval between the diagnosis of AA and transplantation was 26 months (9-156 months). The conditioning regimen consisted of thoracoabdominal irradiation in a dose of 2 Gy, fludarabin (Flu) 100-150 mg/m(2), cyclophosphamide (Cy) 100-200 mg/kg, antithymocyte globulin (ATG) in 11 patients and Flu, Cy, and ATG in 3. A graft-versus-host reaction was prevented with mycophenolate mefetil in all the patients, tacrolimus in 11, and cyclosporin A in 3. Donors were compatible for high-resolution typing of 10/10 and 9/10 alleles in 8 and 6 patients, respectively; the source of a transplant was bone marrow in 13 patients and granulocyte colony-stimulating factor-mobilized peripheral blood precursors in one case. Results. Thirteen patients achieved primary engraftment after single transplantation; one patient did after repeat transplantation. Grades I to II graft-versus-host reaction (GVHR) developed in 9 patients; post engraftment life-threatening infections in 3, extensive chronic GVHR in 2, circumscribed GVHR in 7. All fourteen hemopoietic cell transplant recipients followed for a median 17.5 months (range 1-71 months) were survivors. Conclusion. The likelihood of good survival after unrelated transplantations in AA is much higher than that after continued IST: 100% versus 15 +/- 11%.

引用

页码：41 / 47

页数：7

共 24 条

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