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Knochenmarktransplantation bei Panmyelopathie, akuter Leukämie und chronisch myeloischer Leukämie: Ergebnisse der „Ulmer Transplantationsgruppe“

Bone marrow transplantation for treatment of severe aplastic anaemia, acute leukaemia and chronic granulocytic leukaemia: Results of the “ulm bone marrow transplantation group“

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Summary

From 1972–1983 53 patients underwent bone marrow transplantation. The median age was 18 years (3–41). 27 patients suffered from severe aplastic anaemia, 22 patients had acute leukaemia and 4 patients had chronic granulocytic leukaemia in chronic phase. Out of 22 patients with acute leukaemia, 2 had florid leukaemia, 2 had an early relapse and 18 patients were in first or second remission of their disease. 2/53 patients received a syngeneic transplant, 51/53 patients an allogeneic transplant. 47/51 patients had a HLA-A, B, C-identical, MLC-negative sibling donor, 1/51 had a HLA-A, B-C-identical, MLC-positive sibling donor, 2/51 a HLA-phaenotypical identical parental donor and 1/51 a HLA-identical, MLC-negative unrelated donor. The comparison of the results obtained in patients with severe aplastic anaemia transplanted from 1972–1979 with those transplanted from 1980–1983 shows that the bone marrow transplantation has to be performed in an early stage of the disease before the patients become multiple transfused, sensitized and severely infected and that the conditioning regimen for polytransfused patients has to be more intensive than in untransfused patients. From the patient group transplanted 1972–1979, only 1/14 patients is a long-term survivor in contrast to 8/13 patients transplanted from 1980–1983. 11/22 patients with acute leukaemia are alive between more than 5 years and 14 days after bone marrow transplantation. Only 1/4 patients, who were transplanted not in remission, is alive. For patients with acute leukaemia the bone marrow transplantation should be performed in an early stage of their disease when the tumor burden is small and when the patients are in good clinical condition. 2/4 patients with CGL are alive between 12 months and 3 months after bone marrow transplantation. In our patient group graft versus host disease was the most important problem with a high mortality due to GvHD associated infections.

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Abbreviations

ALG:

Antilymphozyten-Globulin

ALL:

akute lymphatische Leukämie

AML:

akute myeloische Leukämie

ATG:

Anti-T-Zell-Globulin

AUL:

akute undifferenzierte Leukämie

CML:

chronisch myeloische Leukämie

CMV:

Cytomegalie

GvHD:

Transplantat-gegen-Wirt-Reaktion

KMT:

Knochenmarktransplantation

MTX:

Methotrexat

SAA:

schwere Panmyelopathie

SD:

selektive Dekontamination

TBI:

Ganzkörperbestrahlung

TD:

totale Dekontamination

TNI:

totale nodale Bestrahlung

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Authors and Affiliations

  1. Abt. Innere Medizin III, Germany

    R. Arnold, T. Schmeiser, W. Heit, E. Kurrle & H. Heimpel

  2. Abt. Kinderheilkunde II, Germany

    W. Friedrich, E. Kohne & E. Kleihauer

  3. Abt. Transfusionsmedizin, Germany

    S. F. Goldmann & B. Kubanek

  4. Abt. Klinische Physiologie, Germany

    F. Carbonell & T. M. Fliedner

  5. Abt. Strahlentherapie Universität Ulm, Germany

    E. Röttinger

  6. Abt. für Strahlentherapie Universität Freiburg, Germany

    M. Wannenmacher

Authors
  1. R. Arnold
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  2. T. Schmeiser
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  3. W. Friedrich
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  4. F. Carbonell
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  5. S. F. Goldmann
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  6. W. Heit
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  7. E. Kohne
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  8. E. Kurrle
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  9. E. Röttinger
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  10. M. Wannenmacher
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  11. T. M. Fliedner
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  12. E. Kleihauer
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  13. H. Heimpel
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  14. B. Kubanek
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Additional information

Mit Unterstützung der Deutschen Forschungsgemeinschaft, SFB 112, Projekt H 5

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Arnold, R., Schmeiser, T., Friedrich, W. et al. Knochenmarktransplantation bei Panmyelopathie, akuter Leukämie und chronisch myeloischer Leukämie: Ergebnisse der „Ulmer Transplantationsgruppe“. Klin Wochenschr 62, 577–585 (1984). https://doi.org/10.1007/BF01728176

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  • DOI: https://doi.org/10.1007/BF01728176

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