CLINICAL TRIALS AND OBSERVATIONS Prospective multicenter trial comparing repeated immunosuppressive therapy with stem-cell transplantation from an alternative donor as second-line treatment for children with severe and very severe aplastic anemia
نویسندگان
چکیده
1Department of Pediatrics, Hyogo Children Hospital, Hyogo; 2Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi; 3Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo; 4Department of Pediatrics, Hokkaido University Graduate School of Medicine, Hokkaido; 5Department of Pediatrics, Yamaguchi University School of Medicine, Yamaguchi; 6Department of Pediatrics, Kiyose Children’s Hospital, Tokyo; 7Specialized Clinical Science, Pediatrics, Tokai University School of Medicine, Kanagawa; 8Department of Pediatrics, Ibaraki Children’s Hospital, Ibaraki; 9Department of Pediatrics, Nihon University School of Medicine, Tokyo; 10Department of Transfusion, Toho University School of Medicine, Tokyo; 11Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto; 12Department of Pediatrics, Hyogo College of Medicine, Hyogo; 13Department of Pediatrics, Kyushu University Graduate School of Medicine, Fukuoka; 14Department of Pediatrics, Kyorin University School of Medicine, Tokyo; 15Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto; and 16Department of Pediatrics, Toho University School of Medicine, Tokyo, Japan
منابع مشابه
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Immunosuppressive therapy using antithymocyte globulin, cyclosporine, and danazol with or without human granulocyte colony-stimulating factor in children with acquired aplastic anemia
A prospective multicenter trial of 119 children 1 to 18 years of age with newly diagnosed aplastic anemia (AA) was conducted, comparing treatment using antithymocyte globulin (ATG), cyclosporine (CyA), and danazol (DAN) with or without rhG-CSF (400 mg/m2, day on days 1-90). All children with very severe AA received rhG-CSF (VSAA group, n 5 50). The other children were randomized to receive ATG,...
متن کاملCLINICAL TRIALS AND OBSERVATIONS High-dose cyclophosphamide for severe aplastic anemia: long-term follow-up
Severe aplastic anemia (SAA) is a lifethreatening bone marrow failure disorder that can be treated with bone marrow transplantation, immunosuppressive therapy,and high-dose cyclophosphamide. Here, we report long-term follow-up on 67 SAA patients (44 treatment-naiveand23refractory) treated with high-dose cyclophosphamide. At 10 years, the overall actuarial survival was 88%, the response rate was...
متن کاملCLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Long-term outcome after bone marrow transplantation for severe aplastic anemia
From January 1978 to December 2001, 133 patients with severe aplastic anemia (SAA) underwent non-T cell–depleted allogeneic bone marrow transplantation from an HLA-identical sibling donor, at the Hospital Saint Louis using either the combination of cyclophosphamide (Cy) and thoracoabdominal irradiation (TAI; n 100) or Cy and antithymocyte globulin (ATG; n 33), as a conditioning regimen. With 13...
متن کاملNonmyeloablative allogeneic hematopoietic stem cell transplantation.
Allogeneic hematopoietic stem cell transplantation (HSCT) is the most effective treatment for selected hematological malignancies. Its curative potential is largely mediated by an immune-mediated destruction of malignant cells by donor lymphocytes termed graft-versus-leukemia (GVL) effect. However, because of its toxicity, conventional allogeneic HSCT is restricted to younger and fitter patient...
متن کاملCLINICAL TRIALS AND OBSERVATIONS Optimization of conditioning for marrow transplantation from unrelated donors for patients with aplastic anemia after failure of immunosuppressive therapy
In 87 patients with aplastic anemia who failed to respond to immunosuppressive treatment, we determined the minimal dose of total body irradiation (TBI) required when added to antithymocyte globulin (ATG, 30 mg/kg 3) plus cyclophosphamide (CY, 50 mg/kg 4) to achieve engraftment of unrelated donor marrow. TBI was started at 3 200 cGy, to be escalated or deescalated in steps of 200 cGy depending ...
متن کامل