Mismatched family donors for bone-marrow transplantation as treatment for acute leukaemia

35 patients were treated for acute myeloid leukaemia or acute lymphoblastic leukaemia with allogeneic bone-marrow grafts from a parent, child, or sibling who was mismatched at the major histocompatibility complex (MHC). 11 of these patients are alive at least 6 months after grafting, 5 of them after...

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Bibliographic Details
Published inThe Lancet (British edition) Vol. 1; no. 8325; p. 612
Main Authors Powles, R L, Morgenstern, G R, Kay, H E, McElwain, T J, Clink, H M, Dady, P J, Barrett, A, Jameson, B, Depledge, M H, Watson, J G, Sloane, J, Leigh, M, Lumley, H, Hedley, D, Lawler, S D, Filshie, J, Robinson, B
Format Journal Article
LanguageEnglish
Published England 19.03.1983
Subjects
Acute Disease
Adolescent
Adult
Antineoplastic Agents - administration & dosage
Bone Marrow - immunology
Bone Marrow Transplantation
Child
Child, Preschool
Female
Genes, MHC Class II
Graft vs Host Reaction
Histocompatibility Antigens Class II - immunology
Histocompatibility Testing
Humans
Leukemia - immunology
Leukemia - mortality
Leukemia - therapy
Leukemia, Lymphoid - immunology
Leukemia, Lymphoid - therapy
Leukemia, Myeloid, Acute - therapy
Major Histocompatibility Complex
Male
Middle Aged
Nuclear Family
Postoperative Complications - mortality
Pulmonary Edema - mortality
Tissue Donors
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Summary:35 patients were treated for acute myeloid leukaemia or acute lymphoblastic leukaemia with allogeneic bone-marrow grafts from a parent, child, or sibling who was mismatched at the major histocompatibility complex (MHC). 11 of these patients are alive at least 6 months after grafting, 5 of them after more than 2 years. Of the 15 patients aged under 20 at the time of the graft, 8 are alive and well 6 months to 3 years later. Cyclosporin A was given to all patients after grafting. 1 patient died of acute graft-versus-host disease and in 2 other cases this was a major factor in their death. Graft failure caused the death of 2 patients. 4 patients died of recurrent leukaemia. A fatal complication in 12 patients was pulmonary oedema, often associated with convulsions, intravascular haemolysis, and renal failure. Some of these patients had viral or bacterial infections, but in the majority the syndrome was not associated with demonstrable infection. This syndrome, in which the essential lesion appears to be vascular, was much more common in recipients of mismatched than matched grafts. 3 others died from lung disease in which infection was a factor.
ISSN:0140-6736