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Preceding immunosuppressive therapy with antithymocyte globulin and ciclosporin increases the incidence of graft rejection in children with aplastic anaemia who underwent allogeneic bone marrow transplantation from HLA‐identical siblings
Author(s) -
Kobayashi Ryoji,
Yabe Hiromasa,
Hara Junichi,
Morimoto Akira,
Tsuchida Masahiro,
Mugishima Hideo,
Ohara Akira,
Tsukimoto Ichiro,
Kato Koji,
Kigasawa Hisato,
Tabuchi Ken,
Nakahata Tatsutoshi,
Ohga Shoichi,
Kojima Seiji
Publication year - 2006
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2006.06352.x
Subject(s) - ciclosporin , medicine , incidence (geometry) , transplantation , bone marrow , globulin , immunology , human leukocyte antigen , cumulative incidence , gastroenterology , surgery , antigen , physics , optics
Summary The incidence of graft rejection was determined in 66 children with acquired aplastic anaemia (AA) following bone marrow transplantation (BMT) from a related donor. Eleven of 65 evaluable patients experienced either early or late rejection. Multivariate analysis identified previous immunosuppressive therapy with antithymocyte‐globulin (ATG) and ciclosporin (CsA) as a risk factor for graft rejection (relative risk: 16·6, P = 0·001). Patients who received ATG and CsA had a significantly lower probability of failure‐free survival than those who did not (69·7 ± 6·2% vs. 87·9 ± 8·0%, P = 0·044). These results suggest that BMT should be instituted immediately in children with severe AA who have human leucocyte antigen‐identical siblings.