Cyclophosphamide combined with antithymocyte globulin in preparation for allogeneic marrow transplants in patients with aplastic anemia.

摘要: Graft rejection has been a problem after marrow grafts for patients with aplastic anemia who were conditioned cyclophosphamide (CY). Rejection lessened when given the donor's peripheral blood buffy-coat cells in addition to marrow, but this result was achieved at price of more chronic graft-versus-host disease (GVHD). Results second transplants suggested that CY alternating antithymocyte globulin (ATG) immunosuppressive than alone. Therefore, current study explored and ATG without cell transfusions 39 from HLA-identical family members (siblings 38 cases, father 1 case). We hoped both minimize risks graft GVHD improve survival. Patients 2 52 years age (median, 24.5); 87% had received previous transfusions, 41% therapy agents before transplant. They administered four daily doses (total, 200 mg/kg) three 90 followed by an graft. Methotrexate cyclosporine prevent GVHD. Two rejected their (5%), successfully retransplanted. Acute (grade or 3) occurred 15% 34% patients. The actuarial survival rate 3 92%, which compares favorably 72% historical matched risk factors CY/ATG is well-tolerated effective conditioning program grafting that, combined prevention methotrexate/cyclosporine, results excellent