Bone marrow transplantation
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Bone Marrow Transplant. · Jul 1998
Allogeneic bone marrow transplantation for childhood leukemia following a busulfan and melphalan preparative regimen.
Thirty children with leukemia underwent allogeneic bone marrow transplantation (BMT) following a radiation-free preparative regimen, from July 1988 to January 1996. Twelve males and 18 females, ages 9 months to 15 years (median 8.5 years), received busulfan (BU, 4 mg/kg/day for 4 days by mouth), followed by melphalan (L-PAM, 60-70 mg/m2/day i.v. for 3 days), and infusion of allogeneic marrow from an HLA-matched related donor. Diagnoses included acute myelogenous leukemia (n = 20), acute lymphoblastic leukemia (n = 8) and chronic myelogenous leukemia (n = 2). ⋯ As of September 1997, 27 patients were alive and well at 22-110 months (median 61) of follow-up. The disease-free survival rate at 5 years after BMT was 90%. A regimen consisting of high-dose BU and L-PAM without total body irradiation is useful for conditioning for allogeneic BMT in children with leukemia.
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Bone Marrow Transplant. · Jul 1998
Comparative Study Clinical Trial Controlled Clinical TrialComparison between once a day vs twice a day G-CSF for mobilization of peripheral blood progenitor cells (PBPC) in normal donors for allogeneic PBPC transplantation.
Despite the wide use of G-CSF for mobilization of PBPC the best dose and schedule of G-CSF has not been definitively established. In this study we have compared three different schedules of G-CSF for mobilization of PBPC in normal donors including a single daily dose of 10 microg/kg/day for 5 days (21 donors) and doses of 6 (21 donors) or 8 microg/kg/12 h (6 donors) for 5 days. We demonstrate that G-CSF at doses of 6 and 8 microg/kg/12 h mobilizes significantly more CD34+ cells/ml of blood (83.3 +/- 6.7 and 121 +/- 6.9, respectively) than 10 microg/kg/day (71.6 +/- 6.5). ⋯ PBPC collection was associated with a significant decrease in platelet count which was not significantly different between the three groups. Ten days after the last PBPC collection platelet counts were within normal limits while there was a decrease in WBC and ANC. We conclude that G-CSF administered every 12 h at doses of 6 microg/kg provides better CD34+ cell yield than 10 microg/kg once a day in normal donors which may translate into a decrease in the number of aphereses required to obtain enough numbers of CD34+ cells for allogeneic PBPC transplant.
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Bone Marrow Transplant. · Jul 1998
Comparative StudyFaster neutrophil and platelet engraftment, but no differences in acute GVHD or survival, using peripheral blood stem cells from related and unrelated donors, compared to bone marrow.
In this retrospective study, 23 recipients of peripheral blood progenitor cells (PBPC) were compared to 23 recipients of bone marrow (BM). The donors were 12 HLA-A-B-DR identical siblings and 11 HLA-A-B-DR identical unrelated donors in the PBPC and BM groups, respectively. Diagnoses in the PBPC group were CML seven, AML, nine, ALL three, lymphoma one, myeloma two and aspartylglucosaminuria (AGU) one. ⋯ For recovery of platelets >30 x 10(9)/l: PBPCT (P = 0.03) and HLA-identical sibling donors (P = 0.05) were significant in multivariate analysis. A trend towards a lower incidence of bacteremia was seen in the PBPC group, ie 22 vs 48% (P = 0.06) in the BM group. GVHD, TRM and survival did not differ between the two groups.
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Bone Marrow Transplant. · Jul 1998
Clinical TrialCord blood transplantation (CBT) in hemoglobinopathies. Eurocord.
Patients with beta-thalassemia (Hbeta th) and sickle cell anemia (SCA) can be treated with bone marrow transplantation. Stem cells from cord blood have several theoretical advantages, however, the place of cord blood transplant for hemoglobinopathies has not yet been established. We report here the EUROCORD experience of 10 patients (Hbeta th = 7, SCA = 3) transplanted with related cord blood.
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Bone Marrow Transplant. · Jul 1998
Absence of influence of prior treatment with interferon on the outcome of allogeneic bone marrow transplantation for chronic myeloid leukemia.
Timing of transplantation in the chronic phase of chronic myeloid leukemia (CML) and previous treatment with interferon remains controversial. We have tried to discover what influence pretreatment with interferon alpha (IFN-A) has on the results of allogeneic bone marrow transplantation for CML patients treated in a single institution. Fifty-one consecutive patients with chronic phase Ph-positive CML who received an allogeneic bone marrow transplantation from a HLA-identical familial donor were evaluated. ⋯ The incidence of acute and chronic GVHD, VOD and severe mucositis was not significantly different. Relapse and both overall survival and DFS were similar for both groups. No adverse effects of prior IFN exposure on the outcome of HLA-identical sibling donor BMT for chronic phase CML patients were found in this study.