Advertisement

Insight into the Pathophysiology of Aplastic Anemia Provided Through the Results of Marrow Transplantation

  • E. D. Thomas
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 24)

Abstract

The patient with aplastic anemia who has a normal identical twin to serve as marrow donor provides a unique opportunity for therapy by marrow transplantation which in turn offers insight into the basic nature of the disease. In 1964, in describing the second successful such case transplanted in Seattle [16], we argued that restoration of marrow function by a simple infusion of normal marrow, without any conditioning regimen, argued strongly against the disease being due to lack of a nutrient or hormone or a persisting toxic factor. Rather, correction of the defect by an infusion of “stem cells” indicated that the probable mechanism involved an acquired intrinsic stem cell defect. In addition, the etiological agent responsible for the original marrow failure must have been transient in nature.

Keywords

Marrow Transplantation Aplastic Anemia Graft Rejection Paroxysmal Nocturnal Hemoglobinuria Severe Aplastic Anemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Deeg, H. J., Storb, R., Weiden, P. L., Shulman, H. M., Graham, T. C., Torok-Storb, B. J. and Thomas, E. D.: Abrogation of resistance to and enhancement of DLA-nonidentical unrelated marrow grafts in lethally irradiated dogs by thoracic duct lymphocytes. Blood 53, 552–557 (1979)PubMedGoogle Scholar
  2. 2.
    Fefer, A., Freeman, H., Storb, R., Hill, J., Singer, J., Edwards, A. and Thomas, E. D.: Paroxysmal nocturnal hemoglobinuria and marrow failure treated by infusion of marrow from an identical twin. Ann. Intern. Med. 84, 692–695 (1976)PubMedGoogle Scholar
  3. 3.
    Gale, R. P., Falk, P., Feig, S. A. and Cline, M. J. for the UCLA Bone Marrow Transplant Team: Failure of recovery following syngeneic marrow grafting in aplastic anemia. Exp. Hematol. 5, (Suppl. 2), 103 (1977) (abstract)Google Scholar
  4. 4.
    Melvin, K. E. W. and Davidson, J. N. G.: Aplastic anaemia treated by transplantation of isologous bone marrow. N. Z. Med. J. 63, 93–95 (1964)PubMedGoogle Scholar
  5. 5.
    Mills, S. D., Kyle, R. A., Hallenbeck, G. A., Pease, G. L. and Cree, I. C.: Bone-marrow transplant in an identical twin. J. Am. Med. Assoc. 188, 1037–1040 (1964)Google Scholar
  6. 6.
    Pillow, R. P., Epstein, R. B., Buckner, C. D., Giblett, E. R. and Thomas, E. D.: Treatment of bone-marrow failure by isogeneic marrow infusion. N. Engl. J. Med. 275, 94–97 (1966)PubMedCrossRefGoogle Scholar
  7. 7.
    Robins, M. M. and Noyes, W. D.: Aplastic anemia treated with bone-marrow transfusion from an identical twin. N. Engl. J. Med. 265, 974–979 (1961)PubMedCrossRefGoogle Scholar
  8. 8.
    Storb, R., Epstein, R. B., Bryant, J., Ragde, H. and Thomas, E. D.: Marrow grafts by combined marrow and leukocyte infusions in unrelated dogs selected by histocompatibility typing. Transplantation 6, 587–593 (1968)PubMedCrossRefGoogle Scholar
  9. 9.
    Storb, R., Epstein, R. B. and Thomas, E. D.: Marrow repopulating ability of peripheral blood cells compared to thoracic duct cells. Blood 32, 662–667 (1968)PubMedGoogle Scholar
  10. 10.
    Storb, R., Thomas, E. D., Buckner, C. D., Clift, R. A., Johnson, F. L., Fefer, A., Glucksberg, H., Giblett, E. R., Lerner, K. G. and Neiman, P.: Allogeneic marrow grafting for treatment of aplastic anemia. Blood 43, 157–180 (1974)PubMedGoogle Scholar
  11. 11.
    Storb, R., Thomas, E. D., Buckner, C. D., Clift, R. A., Fefer, A., Fernando, L. P., Giblett, E. R., Johnson, F. L. and Neiman, P. E.: Allogeneic marrow grafting for treatment of aplastic anemia: A follow-up on long-term survivors. Blood 48, 485–490 (1976)PubMedGoogle Scholar
  12. 12.
    Storb, R., Thomas, E. D., Weiden, P. L., Buckner, C. D., Clift, R. A., Fefer, A., Fernando, L. P., Giblett, E. R., Goodell, B. W., Johnson, F. L., Lerner, K. G., Neiman, P. E. and Sanders, J. E.: Aplastic anemia treated by allogeneic bone marrow transplantation: A report on 49 new cases from Seattle. Blood 48, 817–841 (1976)PubMedGoogle Scholar
  13. 13.
    Storb, R., Prentice, R. L. and Thomas, E. D.: Marrow transplantation for treatment of aplastic anemia. An analysis of factors associated with graft rejection. N. Engl. J. Med. 296, 61–66 (1977)PubMedCrossRefGoogle Scholar
  14. 14.
    Storb, R. and Thomas, E. D. for the Seattle Marrow Transplant Team: Marrow transplantation for treatment of aplastic anaemia. Clinics in Haematology. Thomas, E. D. (ed.), pp. 597–609, London:Saunders 1978Google Scholar
  15. 15.
    The Royal Marsden Hospital Bone-Marrow Transplantation Team: Failure of syngeneic bone-marrow graft without preconditioning in post-hepatitis marrow aplasia. Lancet II, 742–744 (1977)Google Scholar
  16. 16.
    Thomas, E. D., Phillips, J. H. and Finch, C. A.: Recovery from marrow failure following isogenic marrow infusion. J. Am. Med. Assoc. 188, 1041–1043 (1964)Google Scholar
  17. 17.
    Thomas, E. D., Buckner, C. D., Storb, R., Neiman, P. E., Fefer, A., Clift, R. A., Slichter, S. J., Funk, D.D., Bryant, J. I. and Lerner, K. G.: Aplastic anaemia treated by marrow transplantation. Lancet I, 284–289 (1972)CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1979

Authors and Affiliations

  • E. D. Thomas

There are no affiliations available

Personalised recommendations