The Effects of Multiple Transfusion on the Outcomes of Bone Marrow Transplantation from HLA-matched Sibling Donor in Patients with Severe Aplastic Anemia.
- Author:
Joong Hyun BIN
1
;
Young Kyoung YOO
;
Sun Young KIM
;
Pil Sang JANG
;
Nak Gyun CHUNG
;
Bin CHO
;
Dae Chul JEONG
;
Soon Ju LEE
;
Hack Ki KIM
Author Information
1. Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea. seonyoung@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Severe aplastic anemia;
Multiple transfusion;
Allogeneic bone marrow transplantation
- MeSH:
Anemia, Aplastic*;
Antilymphocyte Serum;
Bone Marrow Transplantation*;
Bone Marrow*;
Child;
Cyclosporine;
Diagnosis;
Disease-Free Survival;
Graft Rejection;
Graft vs Host Disease;
Humans;
Medical Records;
Methotrexate;
Retrospective Studies;
Risk Factors;
Siblings*;
Stem Cells;
Tissue Donors*;
Transplants
- From:Korean Journal of Pediatric Hematology-Oncology
2003;10(1):30-38
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We investigated the effects of pretransplant-transfusion on engraftment, graft versus host disease (GVHD) and graft rejection after bone marrow transplantation (BMT) in children with severe aplastic anemia who had HLA-identical sibling donor. METHODS: We reviewed retrospectively the medical records of 47 children with severe aplastic anemia who received grafts from HLA-matched sibling donor using same conditioning regimen (procarbazine, antithymocyte globulin, and cyclophosphamide) from September 1986 to May 2001. GVHD prophylaxis consisted of cyclosporine and short-term methotrexate. Patients receiving multiple transfusion more than 40 transfused units in total before BMT were defined as high-risk group (HRG) and those with less than 40 transfused units were as standard-risk group (SRG). RESULTS: Among 47 patients, 30 patients were classified into SRG and remaining 17 were into HRG. The median time from diagnosis to transplant was 4 (range, 1~14) months in SRG and 36 (range, 3~360) months in HRG. Primary engraftment was achieved in all patients. Acute GVHD (> or =grade II) in HRG (13.3%) was comparable with in SRG (5.9%) (P=0.221), meanwhile corresponding fugures for chronic GVHD was 1 (3.3%) and 2 (11.8%). All of these patients have experienced complete resolution of GVHD and are no longer receiving immunosuppressive therapy. Booster stem cell infusion was needed for poor graft function (n=3) in SRG and also for poor graft function (n=1) or progressive rejection (n=3) in HRG. Five-year disease free survival rate was 100% in SRG and 94.1 6% in HRG (P=0.18). CONCLUSION: These findings suggest that multiple transfusion may be not a risk factor for rejection or poor outcome. Progressive rejection was observed only in patients with multiple transfusion but did not affect the survival.
