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Cyclophosphamide plus ATG conditioning is insufficient for sustained hematopoletic reconstitution in patients with severe aplastic anemia transplanted with marrow from HLA-A, B, DRB matched unrelated donors
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Bacigalupo A, Broccia G, Corda G, Arcese W, Carotenuto M, Gallamini A, Locatelli F, Mori PG, Saracco P, Todeschini G, et al.: Antilymphocyte globulin, cyclosporin, and granulocyte colony-stimulating factor in patients with acquired severe aplastic anemia (SAA): a pilot study of the EBMT SAA working party. Blood 1995, 85:1348-1353. This pilot study tests the addition of G-CSF to the proven ATG and cyclosporine A regimen for the medical management of acquired SAA. The very favorable early results support this new regimen as an excellent alternative for patients without an HLA-identical sibling BMT donor.
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Bacigalupo, A.1
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Hord JD, Gay JC, Whitlock JA, Janco RL, Edwards JR, Greer JP, Lukens JN: Long-term granulocyte-macrophage colony-stimulating factor and immunosuppression in the treatment of acquired severe aplastic anemia. J Pediatr Hematol Oncol 1995, 17:140-144. Medical treatment of children with SAA treated with ATG, prednisone, cyclosporine, and GM-CSF is beneficial. This regimen results in a decrease in initial morbidity, which the authors postulate is due to the decrease in associated infections secondary to an early increase in the neutrophil count.
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Young NS, Barrett AJ: The treatment of severe acquired aplastic anemia. Blood 1995, 85:3367-3377. This comprehensive review summarizes a large and confusing body of data regarding the pathophysiology of SAA. The authors carefully analyze BMT and immunomodulation for the treatment of SAA. The role of hematopoietic growth factors is also considered.
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