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Allogeneic Peripheral Blood Stem Cell Rescue of Late Graft Failure after Bone Marrow Transplantation in Patients with Aplastic Anemia
Journal of Korean Medical Science ; : 468-474, 2002.
Artículo en Inglés | WPRIM | ID: wpr-216840
ABSTRACT
We investigated the effect and outcome of allogeneic peripheral blood stem cell (PBSC) rescue for aplastic anemia (AA) patients with graft failure after allogeneic bone marrow transplantation (BMT). Seven (28%) of 25 AA patients who received BMT from HLA-identical sibling donors developed late graft failure at a median of 7 months (range, 2.0-9.3 months) after transplantation. The patients with graft failure were treated with PBSC collected from the original donor after mobilization with granulocyte-colony stimulating factor (G-CSF). The median boost dose of peripheral blood mononuclear cells was 3.1 x 10(8)/kg (range, 1.4-11.9 x 10(8)/kg). Median times to reach an absolute neutrophil count greater than 0.5 x 10(9)/L and a platelet count greater than 50 x 10(9)/L were 7 days (range, 4-14 days) and 9 days (range, 3-41 days), respectively. There was sustained graft function in 6 of 7 patients, with a median follow-up duration of 3.3 yr (range, 1.0-6.2 yr). Grade-I acute graft-versus-host disease (GVHD) occurred in 2 patients, while extensive chronic GVHD developed in 3 patients. This report shows that G-CSF-mobilized allogeneic PBSC rescue is very effective in achieving complete and sustained engraftment in patients with AA after graft failure. However, more efficacious measures to prevent extensive chronic GVHD remain to be developed.
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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Trasplante Homólogo / Células Madre Hematopoyéticas / Tasa de Supervivencia / Factor Estimulante de Colonias de Granulocitos / Trasplante de Médula Ósea / Resultado del Tratamiento / Trasplante de Células Madre Hematopoyéticas / Supervivencia de Injerto / Enfermedad Injerto contra Huésped / Anemia Aplásica Límite: Adolescente / Adulto / Niño / Child, preschool / Femenino / Humanos / Lactante / Masculino Idioma: Inglés Revista: Journal of Korean Medical Science Año: 2002 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Trasplante Homólogo / Células Madre Hematopoyéticas / Tasa de Supervivencia / Factor Estimulante de Colonias de Granulocitos / Trasplante de Médula Ósea / Resultado del Tratamiento / Trasplante de Células Madre Hematopoyéticas / Supervivencia de Injerto / Enfermedad Injerto contra Huésped / Anemia Aplásica Límite: Adolescente / Adulto / Niño / Child, preschool / Femenino / Humanos / Lactante / Masculino Idioma: Inglés Revista: Journal of Korean Medical Science Año: 2002 Tipo del documento: Artículo