Subject(s)
Bone Marrow Transplantation , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy , Adolescent , Adult , Child , Child, Preschool , Female , Humans , MaleABSTRACT
An 8-year-old male with idiopathic severe aplastic anemia was successfully treated with allogeneic bone marrow transplantation in June 1980. However, he had a severe aplastic recurrence on the donor marrow after 3 years of sustained and complete engraftment. An alternative immunosuppressive treatment was attempted as a second bone marrow transplantation could not be performed. Consecutive immunosuppressive courses with antithymocyte globulin, antithymocyte globulin plus ciclosporin A and ciclosporin A alone elicited good but transient responses. At present he needs uninterrupted ciclosporin A treatment to maintain normal donor hemopoiesis. An immune-related and persisting pathogeneic mechanism for the aplasia is suspected that responds to diverse and continuous immunosuppression.
Subject(s)
Anemia, Aplastic/therapy , Bone Marrow Transplantation , Immunosuppressive Agents/therapeutic use , Anemia, Aplastic/drug therapy , Antilymphocyte Serum/therapeutic use , Child , Cyclosporins/therapeutic use , Humans , Male , Recurrence , Tissue Donors , Transplantation, HomologousSubject(s)
Leukemia, Myeloid, Acute/complications , Mucormycosis/drug therapy , Otitis/drug therapy , Anemia, Aplastic/chemically induced , Anemia, Aplastic/complications , Antineoplastic Agents/adverse effects , Combined Modality Therapy , Humans , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Mucormycosis/etiology , Mucormycosis/surgery , Otitis/etiology , Otitis/surgerySubject(s)
Bone Marrow Transplantation , Leukemia, Myeloid/therapy , Chromosomes, Human, 21-22 and Y , Evaluation Studies as Topic , Female , Genetic Markers , Graft vs Host Disease , Histocompatibility , Humans , Leukemia, Myeloid/genetics , Leukemia, Myeloid/pathology , Postoperative Complications , Pregnancy , Transplantation, Homologous , Twins, MonozygoticABSTRACT
The authors report 57 febrile episodes in 36 patients with leukemia and lymphoma. Patients with less than 1000 granulocytes and fever above 38.5 degrees C were included in this empirical antibacterial protocol (15 mg amikacin/kg/day/iv, 500 mg carbenicillin/kg/day/iv, 200 mg cefoxitin/kg/day/iv). The criteria for diagnosis of infection were those widely accepted [Schimpff et al. 1971]. Microbiologic documentation of infection was performed in 33.4% of febrile episodes. Antibacterial therapy induced an improvement in 75.1% of cases. Clinical response often occurred in the presence of profound granulocytopenia (in 72% of episodes). Therapy failure was higher in pneumonia (46%) and lower in fever of unknown origin (21%).