<症例>同種骨髄移植施行後に慢性移植片対宿主病を発症した重症再生不良性貧血の2症例

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Two patients with severe aplastic anemia aged 20 and 41 were treated by allogeneic bone marrow transplantation from their HLA-identical siblings. Since they were sensitized to alloantigens through multiple transfusions, total lymphoid irradiation (5Gy) was added to the conventional immunosuppressive conditioning with cyclophosphamide. They received posttransplant buffy coat cells. Cyclosporin A (CyA) was given to the former patient and methotrexate (MTX) to the latter patient to prevent graft-versus-host disease (GVHD). Both patients developed chronic GVHD (de novo late onset type) shortly after the long term immunosuppressive therapy for GVHD prophylaxis. They were treated with prednisolone (PSL) and azathioprine (AZ). As the former patient did not respond to PSL and AZ, CyA was readministered. They are alive on day 960 and day 560 with Karnofsky scores of 90% under immunosuppressive therapy. Thus, long term immunosuppressive therapy may be required to prevent chronic GVHD for such patients with aplastic anemia that received allogeneic bone marrow transplantation after multiple transfusions and posttransplant buffy coat cells.
近畿大学の論文
1987-06-25