GRAFT-VERSUS-HOST DISEASE AND SURVIVAL IN PATIENTS WITH APLASTIC-ANEMIA TREATED BY MARROW GRAFTS FROM HLA-IDENTICAL SIBLINGS - BENEFICIAL EFFECT OF A PROTECTIVE ENVIRONMENT
GRAFT-VERSUS-HOST DISEASE AND SURVIVAL IN PATIENTS WITH APLASTIC-ANEMIA TREATED BY MARROW GRAFTS FROM HLA-IDENTICAL SIBLINGS - BENEFICIAL EFFECT OF A PROTECTIVE ENVIRONMENT
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DOI：
10.1056/nejm198302103080602
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发表时间：
1983-01-01
影响因子：
158.5
通讯作者：
THOMAS, ED
中科院分区：
文献类型：
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作者：
STORB, R;PRENTICE, RL;THOMAS, ED
患有严重再生障碍性贫血的患者（130 名）接受环磷酰胺调理，以移植来自 HLA 相同兄弟姐妹的骨髓。根据持续骨髓移植的标准选择患者进行本分析。在这 130 名患者中，97 名患者在移植后存活 1.4-11 年（中位数为 5 年）。在 33 名死亡者中，有 29 人患有急性或慢性移植物抗宿主病 (GVHD)。该分析旨在确定预测患者移植后 GVHD 和存活率的因素。主要发现是，中重度至重度急性 GVHD 对生存有强烈的不利影响；保护性环境显着降低了死亡率，这在一定程度上与急性 GVHD 的减少和延迟发作相对应；移植时随机供体血小板输注无效会对生存产生不利影响，尤其是患有急性 GVHD 的患者；年龄的增加与死亡率的增加有关。
Patients (130) with severe aplastic anemia were conditioned with cyclophosphamide for transplantation of marrow from HLA-identical siblings. The patients were selected for the present analysis according to the criterion of sustained marrow engraftment. Of the 130 patients, 97 are now alive between 1.4-11 yr (median, 5) after transplantation. Of the 33 who died 29 had either acute or chronic graft vs. host disease (GVHD). The analysis was directed at identifying factors predicting GVHD and survival after transplantation in patients. Key findings were that moderately severe to severe acute GVHD had a strong adverse influence on survival; that a protective environment significantly reduced mortality, which corresponded in part to a reduction in and delayed onset of acute GVHD; that refractoriness to random-donor platelet infusions at transplantation adversely influenced survival, particularly among patients with acute GVHD; and that increasing age was associated with increased mortality.