PMID- 2804361
OWN - NLM
STAT- MEDLINE
DCOM- 19891208
LR  - 20211203
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 74
IP  - 6
DP  - 1989 Nov 1
TI  - Graft failure after T-cell-depleted human leukocyte antigen identical marrow 
      transplants for leukemia: I. Analysis of risk factors and results of secondary 
      transplants.
PG  - 2227-36
AB  - Risk factors for graft failure were analyzed in 122 recipients of an allogeneic 
      T-cell-depleted human leukocyte antigen (HLA)-identical sibling marrow transplant 
      as treatment for leukemia. In each case pretransplant immunosuppression included 
      1,375 to 1,500 cGy hyperfractionated total body irradiation and cyclophosphamide 
      (60 mg/kg/d x 2). No patient received immunosuppression prosttransplant for 
      graft-versus-host disease (GVHD) prophylaxis. Nineteen patients in this group 
      experienced graft failure. The major factors associated with graft failure were 
      transplants from male donors and the age of the patient (or donor). Among male 
      recipients of male donor-derived grafts a low dose per kilogram of nucleated 
      cells, progenitor cells (colony forming unit-GM) and T cells was also associated 
      with graft failure. Additional irradiation to 1,500 cGy, high dose 
      corticosteroids posttransplant, and additional peripheral blood donor T cells did 
      not decrease the incidence of graft failure. In addition, type of leukemia, time 
      from diagnosis to transplant, an intact spleen, or the presence of antidonor 
      leukocyte antibodies did not correlate with graft failure. To ensure engraftment 
      of secondary transplants, further immunosuppression was necessary but was poorly 
      tolerated. However, engraftment and survival could be achieved with an 
      immunosuppressive regimen in which antithymocyte globulin and high dose 
      methylprednisolone were administered both before and after infusions of secondary 
      partially T-cell-depleted marrow grafts.
FAU - Kernan, N A
AU  - Kernan NA
AD  - Charles A. Dana Marrow Transplant Unit, Memorial Sloan-Kettering Cancer Center, 
      New York, NY 10021.
FAU - Bordignon, C
AU  - Bordignon C
FAU - Heller, G
AU  - Heller G
FAU - Cunningham, I
AU  - Cunningham I
FAU - Castro-Malaspina, H
AU  - Castro-Malaspina H
FAU - Shank, B
AU  - Shank B
FAU - Flomenberg, N
AU  - Flomenberg N
FAU - Burns, J
AU  - Burns J
FAU - Yang, S Y
AU  - Yang SY
FAU - Black, P
AU  - Black P
AU  - et al.
LA  - eng
GR  - CA08748/CA/NCI NIH HHS/United States
GR  - CA22507/CA/NCI NIH HHS/United States
GR  - NCI-CA23766/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Antilymphocyte Serum)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Age Factors
MH  - Antilymphocyte Serum/therapeutic use
MH  - Bone Marrow Transplantation/*immunology/pathology
MH  - Female
MH  - *Graft Survival
MH  - Histocompatibility
MH  - Immunosuppression Therapy
MH  - Leukemia/*surgery
MH  - Leukocyte Count
MH  - Male
MH  - Methylprednisolone/therapeutic use
MH  - Multivariate Analysis
MH  - Risk Factors
MH  - Sex Factors
MH  - T-Lymphocytes/*immunology
EDAT- 1989/11/01 00:00
MHDA- 1989/11/01 00:01
CRDT- 1989/11/01 00:00
PHST- 1989/11/01 00:00 [pubmed]
PHST- 1989/11/01 00:01 [medline]
PHST- 1989/11/01 00:00 [entrez]
AID - S0006-4971(20)85010-1 [pii]
PST - ppublish
SO  - Blood. 1989 Nov 1;74(6):2227-36.