Bacigalupo A, Hows J, Gordon-Smith E C, Gluckman E, Van Lint M T, Congiu M, James D C, Barrett A J, Gmur J, De Planque M M
Division di Ematologia, Ospedale San Martino, Genova, Italy.
Bone Marrow Transplant. 1988 Nov;3(6):531-5.
Data were obtained from 46 patients with severe aplastic anemia (SAA) who received bone marrow transplants (BMT) from donors other than genotypically HLA-identical siblings. The data were collected in the SAA Registry of the European Bone Marrow Transplant Group. The donors were non-HLA-identical siblings in six cases, parents in 28 cases, a son in one case and unrelated individuals in 11 cases. Fifteen donor-recipient pairs were HLA-A, -B and -DR identical and mutually non-reactive in mixed lymphocyte culture; nine were mismatched at one locus, 17 were mismatched at two or more loci and in five cases data were not available for D/DR determinants. Actuarial survival was predicted by the degree of mismatch. It was 45% for phenotypically HLA-identical grafts, 25% for grafts mismatched at one locus and 11% for graft mismatched at more than one locus. Whether the graft was derived from a family member or an unrelated donor seemed to be less important and results were comparable. Age, patient sex and year of transplant had no significant influence on survival. The use of cyclosporine (CSA) for graft-versus-host disease (GVHD) prophylaxis (n = 21, survival 34%) appeared superior to both methotrexate (n = 9, survival 11%) and to CSA with T cell depletion of donor marrow (n = 13, survival 14%). The causes of death were rejection (n = 15), GVHD (n = 13), pneumonitis (n = 5) and infection (n = 1). Twelve patients are alive at 16-84 months post-BMT.(ABSTRACT TRUNCATED AT 250 WORDS)
数据来自46例重型再生障碍性贫血（SAA）患者，这些患者接受了非基因型HLA相同同胞供者的骨髓移植（BMT）。数据收集于欧洲骨髓移植组的SAA登记处。供者为非HLA相同同胞的有6例，父母28例，儿子1例，无关个体11例。15对供受者HLA - A、- B和 - DR相同，且在混合淋巴细胞培养中相互无反应；9对在一个位点不匹配，17对在两个或更多位点不匹配，5例缺乏D/DR决定簇的数据。精算生存率由不匹配程度预测。表型HLA相同移植物的生存率为45%，一个位点不匹配移植物的生存率为25%，一个以上位点不匹配移植物的生存率为11%。移植物来自家庭成员还是无关供者似乎不太重要，结果相近。年龄、患者性别和移植年份对生存率无显著影响。使用环孢素（CSA）预防移植物抗宿主病（GVHD）（n = 21，生存率34%）似乎优于甲氨蝶呤（n = 9，生存率11%）和去除供者骨髓T细胞的CSA（n = 13，生存率14%）。死亡原因包括排斥反应（n = 15）、GVHD（n = 13）、肺炎（n = 5）和感染（n = 1）。12例患者在BMT后16 - 84个月存活。（摘要截断于250字）
