Cytogenetics and bone marrow transplantation

Comparison of Outcomes after Transplantation of G-CSF–Stimulated Bone Marrow Grafts versus Bone Marrow or Peripheral Blood Grafts from HLA-Matched Sibling Donors for Patients with Severe Aplastic Anemia

The Triterpenoid CDDO-Me Delays Murine Acute Graft-versus-Host Disease with the Preservation of Graft-versus-Tumor Effects after Allogeneic Bone Marrow Transplantation

Leukemia Lineage-Specific Chimerism Analysis and Molecular Monitoring Improve Outcome of Donor Lymphocyte Infusions

Safety and Efficacy of CMX001 as Salvage Therapy for Severe Adenovirus Infections in Immunocompromised Patients

CMV Infection after Transplant from Cord Blood Compared to Other Alternative Donors: The Importance of Donor-Negative CMV Serostatus

Minimal Residual Disease following Allogeneic Hematopoietic Stem Cell Transplantation

Sirolimus as Primary Treatment of Acute Graft-versus-Host Disease following Allogeneic Hematopoietic Cell Transplantation

Objective To explore the efficacy of allogeneic hematopeietic stem cell transplantation in children with aplastic anemia. Methods In six children with aplastic anemia, five children received G-CSF primed allogeneic bone marrow plus peripheral stem cell transplantation from HLA-matched siblings, the nucleat- ed cell dose of BM and PBSC transplanted was respectively 4. 61 ( 1.5 ～ 13.2)×108/kg and 9. 36(2. 05 ～ 16. 75 )×108/kg. All five cases used FLU + CTX + ATG as the conditioning regimens. One child received unre-lated HLA-matched bone marrow transplantation, the nucleated cell dose of BM transplanted was 16. 8 x 10S/kg, and used FLU + CTX + TBI as the conditioning regimen. All cases received CSA + MTX + MMF as acute GVHD prophylaxis. Results One child got graft failure and the hematopoiesis recovered at 23 days by itself. The other five children achieved hematopoietic recovery after transplantation. None of them got GVHD after transplanta-tion. One child who had got MAA for four years happened graft rejection,got disease recurrence and finally died of serious infection. Other five children got disease-free survival with a follow-up to Feb 2009. Conclusion AI-logeneic bone marrow plus peripherial stem cell transplantation from HLA-matched siblings could be considered as the preferred treatment for children with aplastic anemia. It is feasible for children with aplastic anemia to re-ceive bone marrow transplant from unrelated HLA-matched donors when the patient was failed in immunosup-pressive therapy and without an available sibling donor. Key words: Hematopeietic stem cell transplantation; Aplastic anemia; Children

In severe aplastic anaemia, the treatment of choice for young patients with a human leucocyte antigen-matched sibling is now established as allogeneic bone marrow transplantation (BMT). In older patients and in those without a matched sibling donor, immunosuppressive therapy is the usual first option. 'Alternative' marrow donors are emerging as an option for those without a matched sibling donor. To review 10 years of local experience in treating severe aplastic anaemia with BMT and immunosuppressive therapy with emphasis on long-term outcomes. A retrospective analysis was performed of all patients with severe aplastic anaemia presenting to the Royal Brisbane and Royal Children's Hospitals between 1989 and 1999. Data were abstracted regarding patient demographics, pretreatment characteristics and outcome measures, including response rates, overall survival and long-term complications. Twenty-seven consecutive patients were identified, 12 treated with immunosuppression alone and 15 with BMT. In these two groups, transfusion independence was attained in 25% and 100%, respectively, with overall survival being 36% and 100%, respectively. Those treated with immunosuppression were significantly older (median 41.5 versus 22 years, P = 0.008). Long-term survivors of either treatment had extremely low morbidity. Three patients carried pregnancies to term post-transplant. Three patients received alternative donor BMT with correspondingly excellent survival. Patients treated with allogeneic BMT for severe aplastic anaemia enjoyed extremely good long-term survival and minimal morbidity. Patients treated with immunosuppressive therapy had a poorer outcome reflecting their older age and different usage of therapies over the past decade. Optimal treatment strategies for severe aplastic anaemia remain to be determined.

Autoimmune diseases can be transmitted and eliminated by bone marrow transplantation (BMT). There have been several cases of autoimmune thyroid disease (AITD) occurring after BMT, but AITD remission has been rarely reported. We present four cases in which the remission or transfer of AITD occurred after an allogeneic BMT. Two patients with severe aplastic anemia (SAA) showed evidence of remission of Hashimoto's thyroiditis which they had before allogeneic BMT. One patient with SAA, which developed during treatment with propylthiouracil for Graves' disease, underwent allogeneic BMT and showed evidence of Graves' disease remission following BMT. In one patient, new AITD occurred after an allogeneic BMT from an HLA-matched sibling who already had AITD. These cases support the evidence that the immune system is newly reconstituted after BMT, and severe autoimmune disease can be an indication for BMT. To fully understand the real changes in autoimmune status after BMT, long-term prospective studies are necessary.

Late Mortality after Allogeneic Bone Marrow Transplantation in Childhood for Bone Marrow Failure Syndromes and Severe Aplastic Anemia

Severe aplastic anemia: allogeneic bone marrow transplantation as first-line treatment

Feasibility and Safety of Adoptive Immunotherapy with CIK Cells after Cord Blood Transplantation

Lymphocyte depletion of donor bone marrow by counterflow centrifugal elutriation: results of a phase I clinical trial

To report two cases of successful spouse pregnancies which were conceived with long-term cryopreserved spermatozoa that had been collected prior to the male patients receiving a bone marrow transplant. The first case is the pregnant wife of a 25-year-old man with chronic myelogenous leukemia, whose semen was collected before bone marrow transplant and then cryopreserved, thawed, and then injected into the wife's eggs via ICSI. The second case is a 28-year-old man with severe aplastic anemia who became a father after his wife's eggs were fertilized via ICSI with thawed spermatozoa. These two cases were achieved pregnancies. These cases support research that men with malignancy have the chance of fathering their own genetic children. Therefore, it is important to increase the awareness of clinicians, oncologists, and patients to the new developments in preserving fertility for cancer patients.