Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1981 Mar 14;282(6267):860–863. doi: 10.1136/bmj.282.6267.860

Treatment of severe aplastic anaemia with antilymphocyte globulin or bone-marrow transplantation.

B Speck, A Gratwohl, C Nissen, U Leibundgut, D Ruggero, B Osterwalder, H P Burri, P Cornu, M Jeannet
PMCID: PMC1504686  PMID: 6783204

Abstract

Fifty-three patients with severe aplastic anaemia were admitted to this hospital between January 1976 and June 1980, of whom three arrived in terminal condition and died before treatment for their basic disease could be given. Thus 50 patients were treated and evaluated in a prospective study according to one protocol. Eighteen patients with an HLA-identical sibling underwent bone-marrow transplantation with the aim of achieving haematopoietic chimerism. Thirty-two patients without an HLA-identical sibling were given antilymphocyte globulin with or without an infusion of HLA-haplotype-identical marrow. All these 32 patients received low-dose androgens after the procedure. In the first group eight patients (44%) survived. In the two other groups, 22 patients survived (69%), of whom 20 were completely self-sustaining (63%). Engraftment and graft-versus-host disease did not occur in the group who received antilymphocyte globulin and haploidentical marrow, and the haematopoietic reconstitutions in these patients were all autologous. These results confirm the efficacy of antilymphocyte globulin in the treatment of severe aplastic anaemia and show that such treatment is at least as good as bone-marrow transplantation. Its mechanism of action remains unknown, but most patients with aplastic anaemia have a pool of haematopoietic stem cells able to repopulate the marrow after this type of treatment.

Full text

PDF
860

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Camitta B. M., Thomas E. D., Nathan D. G., Gale R. P., Kopecky K. J., Rappeport J. M., Santos G., Gordon-Smith E. C., Storb R. A prospective study of androgens and bone marrow transplantation for treatment of severe aplastic anemia. Blood. 1979 Mar;53(3):504–514. [PubMed] [Google Scholar]
  2. Mathé G., Amiel J. L., Schwarzenberg L., Choay J., Trolard P., Schneider M., Hayat M., Schlumberger J. R., Jasmin C. Bone marrow graft in man after conditioning by antilymphocytic serum. Br Med J. 1970 Apr 18;2(5702):131–136. doi: 10.1136/bmj.2.5702.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Nissen C., Cornu P., Gratwohl A., Speck B. Peripheral blood cells from patients wih aplastic anaemia in partial remission suppress growth of their own bone marrow precursors in culture. Br J Haematol. 1980 Jun;45(2):233–243. doi: 10.1111/j.1365-2141.1980.tb07143.x. [DOI] [PubMed] [Google Scholar]
  4. Ramsay N. K., Kim T., Nesbit M. E., Krivit W., Coccia P. F., Levitt S. H., Woods W. G., Kersey J. H. Total lymphoid irradiation and cyclophosphamide as preparation for bone marrow transplantation in severe aplastic anemia. Blood. 1980 Feb;55(2):344–346. [PubMed] [Google Scholar]
  5. Speck B., Buckner C. D., Cornu P., Jeannet B. Rationale for the use of ALG as sole immunosuppressant in allogeneic bone marrow transplantation for aplastic anemia. Transplant Proc. 1976 Dec;8(4):617–622. [PubMed] [Google Scholar]
  6. Speck B., Gluckman E., Haak H. L., van Rood J. J. Treatment of aplastic anaemia by antilymphocyte globulin with and without allogeneic bone-marrow infusions. Lancet. 1977 Dec 3;2(8049):1145–1148. doi: 10.1016/s0140-6736(77)91537-9. [DOI] [PubMed] [Google Scholar]
  7. Speck B., Kissling M. Successful bone marrow grafts in experimental aplastic anemia using antilymphocytic serum for conditioning. Rev Eur Etud Clin Biol. 1971 Dec;16(10):1047–1051. [PubMed] [Google Scholar]
  8. Storb R. Decrease in the graft rejection rate and improvement in survival after marrow transplantation for severe aplastic anemia. Transplant Proc. 1979 Mar;11(1):196–198. [PubMed] [Google Scholar]
  9. Storb R., Prentice R. L., Thomas E. D. Marrow transplantation for treatment of aplastic anemia. An analysis of factors associated with graft rejection. N Engl J Med. 1977 Jan 13;296(2):61–66. doi: 10.1056/NEJM197701132960201. [DOI] [PubMed] [Google Scholar]
  10. Storb R., Prentice R. L., Thomas E. D. Treatment of aplastic anemia by marrow transplantation from HLA identical siblings. Prognostic factors associated with graft versus host disease and survival. J Clin Invest. 1977 Apr;59(4):625–632. doi: 10.1172/JCI108680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Storb R., Thomas E. D. Human marrow transplantation. Transplantation. 1979 Jul;28(1):1–3. [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES