[Experience with 22 bone marrow donors]. / Experiencia con 22 donadores de médula ósea.

We describe our experience of the Instituto Nacional de Cancerología in Mexico City in the management of 22 healthy donors of the allogeneic bone marrow transplantation program. Twenty three bone marrow products were harvested from the 22 healthy donors (7 male, 15 female) with a median age of 26 (range 16 to 47). All were seronegative for HIV, HBV and HCV. The volume harvested ranged from 750 to 1500 mL. The postoperative hemoglobin dropped more than 3 g/dL in 14 donors but only seven required the transfusion of autologous blood collected before the procedure. All donors received a standard analgesic regimen with meperidene, dextropropoxiphene and ketoprofen for 24 hours after the harvest. Only two instances of procedure complications were recorded (9%) and were successfully resolved. Currently all donors are alive and in good health with a median follow up of two years. We conclude that bone marrow donation is a safe procedure with some predictable complications, the most common, anemia, easily corrected with autologous blood transfusion.

Misoprostol prophylaxis for high-dose chemotherapy-induced mucositis: a randomized double-blind study.

From April 1993 to September 1993, 15 patients with lymphoid or solid neoplasms underwent 16 non-cryopreserved peripheral stem cell transplantation courses using the ICE (ifosfamide, carboplatin, etoposide) program. They were randomized in a double-blind clinical trial to received oral misoprostol or placebo for mucositis prophylaxis. The active drug or placebo administration began jointly with chemotherapy at day -4 and was continued until day 16. The mucositis incidence and severity was significantly higher in patients who received misoprostol. We found no differences regarding myelosuppression, infections or other chemotherapy complications. Our results do not support the use of oral misoprostol as administered in this study, for high-dose chemotherapy-induced mucositis prophylaxis.

[Prevention of myelotoxicity in a case of bone marrow transplantation using granulocyte-macrophage colony-stimulating factor along with ganciclovir]. / Prevención de mielotoxicidad en un caso de trasplante medular con factor estimulante de colonias granulocito-macrófago asociado a ganciclovir.

We report the first experience of the use of GM-CSF as prophylaxis of ganciclovir induced severe bone marrow suppression in a CMV seropositive patient with acute myeloid leukemia who underwent a complete remission after an allogeneic bone marrow transplantation from an identical HLA sibling who also was CMV seropositive. A successful bone marrow engraftment was documented by day 14. Once peripheral blood counts stabilized, the patient received ganciclovir 5 mg/kg TIW. By day 73 severe neutropenia was documented but a spontaneous improvement occurred with discontinuation of ganciclovir. From day 100 to day. 110 he received daily ganciclovir at a dose of 5 mg/kg and the same dose of GM-CSF without signs of toxicity. There was no evidence of either acute graft versus host disease or of CMV infection. One year after transplantation he relapsed and died of complications of acute leukemia.