SUCCESSFUL MARROW RE-TRANSPLANTATION FOLLOWING FAILURE OF FIRST TRANSPLANT FOR APLASTIC ANEMIA

Abstract

An 11 year old girl with aplastic anemia of unknown etiology was transplanted with MLC and HLA identical sibling marrow following 4 doses of Cyclophosphamide (CY) 50 mg/kg. She had received multiple blood transfusions before transplantation (TP). Three weeks following TP the marrow was repopulating, but 4 weeks later the marrow was again aplastic. Immunosuppression with Procarbazine, anti-thymocyte globulin, and a repeat course of CY were given followed by a second TP from the same donor. A take of donor marrow cells now occurred and has persisted to the present (140 days after TP). No evidence of graftversus-host disease was seen; PHA responsive peripheral blood lymphocytes have remained predominantly of host type. The patient has remained in excellent clinical health. Her B cell function is normalizing, but her T cell function is as yet depressed.