Treatment of Aplastic Anemia: Bone Marrow Transplantation, Immunomodulatory Therapy, and Hematopoietic Growth Factors

Champlin, Richard E.

doi:10.1007/978-1-4612-3254-4_11

Aplastic Anemia and Other Bone Marrow Failure Syndromes 1990

DOI: 10.1007/978-1-4612-3254-4_11

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Treatment of Aplastic Anemia: Bone Marrow Transplantation, Immunomodulatory Therapy, and Hematopoietic Growth Factors

Richard E. Champlin¹

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1992

1999

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Cited by 3 publications

(2 citation statements)

References 49 publications

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“…Allogeneic bone marrow transplantation (BMT) from HLAidentical sibling donors has been accepted as a cureoriented treatment for patients with hematological malignancies, [1][2][3] syndromes of marrow failure [4][5][6] and certain hereditary disorders. 7 It has been, nevertheless, a possible modality of treatment only for approximately one-third of the patients for whom BMT is the first choice of treatment because of the lack of HLA-matched related donors.…”

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confidence: 99%

Analysis of 500 bone marrow transplants from unrelated donors (UR-BMT) facilitated by the Japan Marrow Donor Program: confirmation of UR-BMT as a standard therapy for patients with leukemia and aplastic anemia

Kodera¹,

Morishima

Kato

et al. 1999

Bone Marrow Transplant

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Among these matched pairs, 1829 unrelated bone marrow transplants (UR-BMT) were performed. The initial 500 UR-BMT transplanted from January 1993 to October 1995 were analyzed as of July 1998. Engraftment was achieved in 95% of cases. Probability of the occurrence of grade III and IV acute GVHD was 18.4%. The rate of disease-free survival (DFS) of the patients who had standard-risk leukemia and did not suffer from grade III or IV acute GVHD (n = 154) was 60-71% and the rate of survival of patients with aplastic anemia was 56%. It can be stated that UR-BMT is a modality of treatment which is as effective as related BMT if the occurrence of grade III or IV acute GVHD is predicted and prevented.

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mentioning

confidence: 99%

Analysis of 500 bone marrow transplants from unrelated donors (UR-BMT) facilitated by the Japan Marrow Donor Program: confirmation of UR-BMT as a standard therapy for patients with leukemia and aplastic anemia

Kodera¹,

Morishima

Kato

et al. 1999

Bone Marrow Transplant

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“…Several clinical trials have since demonstrated that ALG as well as antithymocyte globulin (ATG) improves both survival and haematologic recovery when compared to standard therapy for severe aplastic anaemia (9-14). The results reported from some studies in the literature are so encouraging that immunosuppression by ALG/ATG has been considered to be a substitute for bone marrow trans-plantation, the most effective therapeutic modality in aplastic anaemia (9,15,16).…”

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confidence: 99%

Effect of androgens on the response to antithymocyte globulin in patients with aplastic anaemia

Kaltwasser

Dix

Schalk

et al. 1988

European J of Haematology

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30 patients with aplastic anaemia (18/30 with severe aplastic anaemia) were prospectively randomized to be treated with 100 mg/kg ATG with or without the oral androgen Methenolone (3 mg/kg). 15 of 30 patients responded. Among the 15 patients receiving ATG plus androgen, 11 patients (73 Olo) responded, including 8 complete and 3 partial responses. 4 of the 15 patients (31%) receiving ATG only responded, including 2 complete and 2 partial responses. The difference in response rate was statistically significant (p = 0.01). The survival rate in the total population of 30 patients was 64%. The survival rate in the group receiving ATG plus androgen was 87%; in the group receiving ATG only it was 43%. The difference in survival rates between both groups did not reach statistical significance (p = 0.15). Toxicity of ATG and androgens was considerable but manageable. These data support the result of the recent European reevaluation of a large pool of patients by the EBMT (39), that androgens in addition to ATG increase survival in patients with aplastic anaemia. They are, however, in contradiction to a controlled American study showing no benefit of a combined treatment with androgens as compared to ATG only. Further controlled studies on a larger number of patients are indicated to determine the therapeutic efficacy of androgens in addition to immunosuppression in aplastic anaemia.

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Poor Clinical Outcome of Patients Developing Malignant Solid Tumors after Bone Marrow Transplantation for Severe Aplastic Anemia

Socié

Henry-Amar

Devergié

et al. 1992

Leukemia & Lymphoma

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From January 1974 to September 1991, 245 consecutive patients with severe aplastic anemia underwent bone marrow transplantation at the Hôpital Saint-Louis, Paris, France. Five cases of solid tumor were observed overall, a number that leads to an 8-year cumulative incidence rate of 7.7% (95% CL: 0.9%, 14.5%). Relative to the general population, the risk was equal to 22 (95% CL: 7, 51; p < 0.001). The present report focuses on the unusual clinical course of patients developing malignant tumors after bone marrow transplantation for severe aplastic anemia. It also aims at reporting the difficulty encountered in comparing data from different sources.

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Treatment of Aplastic Anemia: Bone Marrow Transplantation, Immunomodulatory Therapy, and Hematopoietic Growth Factors

Cited by 3 publications

References 49 publications

Analysis of 500 bone marrow transplants from unrelated donors (UR-BMT) facilitated by the Japan Marrow Donor Program: confirmation of UR-BMT as a standard therapy for patients with leukemia and aplastic anemia

Analysis of 500 bone marrow transplants from unrelated donors (UR-BMT) facilitated by the Japan Marrow Donor Program: confirmation of UR-BMT as a standard therapy for patients with leukemia and aplastic anemia

Effect of androgens on the response to antithymocyte globulin in patients with aplastic anaemia

Poor Clinical Outcome of Patients Developing Malignant Solid Tumors after Bone Marrow Transplantation for Severe Aplastic Anemia

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