Marrow transplantation for hepatitis-associated aplastic anemia: a follow-up of long-term survivors.

摘要: Between 1971 and 1989 we have treated 19 patients with hepatitis-associated aplastic anemia by marrow transplantation from their HLA-identical siblings following conditioning 200 mg/kg cyclophosphamide (Cy) administered over a period of 4 days. One patient failed to engraft day 34 was given second transplantation. He died infection 15 days after the Eighteen had sustained engraftment. Six developed acute graft-vs.-host disease (GVHD) two these 2.8 3.3 months Fifteen are surviving 24 (median 13) years transplantation, while one in car accident 17 successful chronic GVHD. Two GVHD preceding four did not. Five six received donor buffy coat cells addition inoculum prevent graft rejection. Twelve Karnofsky performance scores 100%. patient, living more than has score 40% because persistent cognitive deficits non-A, non-B hepatitis hepatic coma. C 12 18 respectively. Except for mild fatigue mildly elevated liver function tests, doing well between 95 severe coronary artery 10 decreasing his 80%. Serum samples before 13 were tested B virus (HBV) DNA (HCV) RNA polymerase chain reaction (PCR). Only positive HCV Seven sera RNA-positive posttransplantation, but only active C. All negative surface antigen HBV DNA. IgM antibodies against A (HAV) which suggested HAV infection. Hepatitis-associated apparently caused most non-B, non-C agent. Cy as regimen is well-tolerated long-term event-free survival excess 80%, not different results transplantations other etiologies.