Document Detail


Marrow graft rejection and veno-occlusive disease of the liver in patients with aplastic anemia conditioned with cyclophosphamide and cyclosporine.
MedLine Citation:
PMID:  3538535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Based on studies in multiply transfused dogs showing that cyclosporine (CsA) pregrafting reduced the incidence of rejection, we treated 11 multiply transfused patients with severe aplastic anemia with CsA, 12.5-20 mg/kg/day i.m. on days -6 to -1, and cyclophosphamide, 50 mg/kg/day i.v. on days -5 to -2, followed on day 0 by a marrow graft from an HLA-identical sibling donor. Patients were not given additional infusions of buffy coat cells from their marrow donors. As postgrafting prophylaxis for graft-versus-host disease 10 patients were given CsA, 12.5 mg/kg/day orally, and one patient was given a standard regimen of intermittent methotrexate. Among 10 evaluable patients, 2 rejected their marrow grafts. Eight patients had sustained engraftment. Two of these developed severe veno-occlusive disease of the liver, a complication previously observed only in patients conditioned with total-body irradiation but not in more than 200 patients with aplastic anemia conditioned with cyclophosphamide without the addition of CsA. These data indicate that conditioning of patients with cyclophosphamide and concurrent CsA does not uniformly prevent graft rejection and can result in severe hepatic toxicity.
Authors:
H J Deeg; H M Shulman; E Schmidt; G C Yee; E D Thomas; R Storb
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Transplantation     Volume:  42     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  1986 Nov 
Date Detail:
Created Date:  1987-01-02     Completed Date:  1987-01-02     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  497-501     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anemia, Aplastic / therapy*
Bone Marrow Transplantation*
Cyclophosphamide / adverse effects*
Cyclosporins / adverse effects*,  blood
Female
Graft Rejection*
Graft vs Host Disease / etiology
Hepatic Veno-Occlusive Disease / chemically induced*
Humans
Kidney / drug effects
Liver / drug effects
Male
Grant Support
ID/Acronym/Agency:
CA 18029/CA/NCI NIH HHS; CA 30924/CA/NCI NIH HHS; CA 33252/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Cyclosporins; 50-18-0/Cyclophosphamide

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


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