Document Detail


Cyclosporin A in marrow transplantation for leukemia and aplastic anemia.
MedLine Citation:
PMID:  3886417     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A total of 29 consecutive patients with leukemia or aplastic anemia who received an HLA-identical marrow graft were given cyclosporin A (CyA) to prevent graft-versus-host disease (GvHD). These patients were compared with an historic group of 25 similar patients with leukemia or AA given methotrexate (MTX) for GvHD prophylaxis at this institution. Engraftment was faster in patients given CyA when compared with MTX patients, with less days of granulocytopenia (P = 0.04), a shorter interval before reaching a platelet count of 70 X 10(9)/l (P = 0.04), fewer major infections (P = 0.01), and fewer days on intravenous antibiotics (P = 0.02). There were no graft failures in CyA patients compared with four of 25 in MTX patients (P = 0.01). Early mortality was lower in CyA patients but not significantly (P = 0.06). The incidence of pulmonary complications was comparable, five of 29 and seven of 25 in CyA and MTX patients, respectively, but the clinical features of such complications differed. Interstitial pneumonia developing after day 30 was seen in MTX patients, whereas an acute respiratory distress syndrome developing between day +8 and day +18 was seen in CyA patients. Acute GvHD was less severe in CyA patients (P = 0.04), but chronic GvHD was comparable (P = 0.3). The actual one-year survival is currently 72% and 52% in CyA and MTX patients, respectively (P = 0.1). Although our initial experience with CyA is encouraging with regard to engraftment and acute GvHD, optimization of CyA protocols will probably be needed for it to be proven as having a definite advantage over MTX.
Authors:
A Bacigalupo; F Frassoni; M T van Lint; M R Raffo; V Vitale; G Corbetta; S Chierichetti; A M Marmont
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Experimental hematology     Volume:  13     ISSN:  0301-472X     ISO Abbreviation:  Exp. Hematol.     Publication Date:  1985 May 
Date Detail:
Created Date:  1985-05-30     Completed Date:  1985-05-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0402313     Medline TA:  Exp Hematol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  244-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anemia, Aplastic / therapy*
Bone Marrow Transplantation*
Child
Child, Preschool
Cyclosporins / adverse effects,  therapeutic use*
Female
Graft vs Host Disease / prevention & control
Hirsutism / chemically induced
Humans
Kidney / drug effects
Leukemia / therapy*
Liver / drug effects
Lung Diseases / etiology
Male
Methotrexate / therapeutic use
Nausea / chemically induced
Tremor / chemically induced
Vomiting / chemically induced
Chemical
Reg. No./Substance:
0/Cyclosporins; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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