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Treatment of Severe Aplastic Anemia: A 12-Year Follow-Up of Patients after Bone Marrow Transplantation or after Therapy with Antilymphocyte Globulin

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Aplastic Anemia and Other Bone Marrow Failure Syndromes

Abstract

Of 145 patients with severe aplastic anemia (SAA) treated in Basel from 1976 to January 1988, 34 with HLA identical siblings had bone marrow transplants (BMT) and 111 were treated with antilymphocyte globulin (ALG). We have analyzed the incidence of late complications in both groups of patients. Thirty-two patients treated with ALG developed a hematological complication: 10 of them a myelodysplastic syndrome (MDS) and 18 paroxysmal nocturnal hemoglobinuria (PNH). Twelve of the 18 PNH patients were clinically symptomatic. Two patients had both MDS and PNH and 8 patients of the ALG group had a relapse of SAA. After BMT none of these complications was observed. Most of the nonhematological problems were associated with therapy. In the ALG group, androgens were responsible for impotence and gynecomastia in men and a low voice in women. Four patients developed hepatic tumors. Aseptic necrosis of the hip was seen in 4 patients and one developed breast cancer. The most serious late complication after BMT was chronic graft-versus-host disease (GvHD) in patients receiving methotrexate (MTX) for prophylaxis against GvHD.

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Authors
  1. B. Speck
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  2. A. Tichelli
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  3. A. Gratwohl
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  4. C. Nissen
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Editor information

Editors and Affiliations

  1. Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin, 53792, USA

    Nasrollah T. Shahidi

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© 1990 Springer-Verlag Inc.

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Speck, B., Tichelli, A., Gratwohl, A., Nissen, C. (1990). Treatment of Severe Aplastic Anemia: A 12-Year Follow-Up of Patients after Bone Marrow Transplantation or after Therapy with Antilymphocyte Globulin. In: Shahidi, N.T. (eds) Aplastic Anemia and Other Bone Marrow Failure Syndromes. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3254-4_8

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  • DOI: https://doi.org/10.1007/978-1-4612-3254-4_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7935-8

  • Online ISBN: 978-1-4612-3254-4

  • eBook Packages: Springer Book Archive

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