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KMID : 0391319920020020247
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Korean Journal of Biological Response Modifiers
1992 Volume.2 No. 2 p.247 ~ p.256
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GM-CSF Therapy for Late Graft Failure after Allogenic Bone Marrow Transplantation in a Case with Severe Aplastic Anemia
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민유홍
박석원/한지숙/이선주/남동기/서창옥/김현옥/고윤웅
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Abstract
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Graft failure owing to rejection and other causes an important, life-threatening complication following allogeneic bone marrow transplantation for severe aplastic aplastic anemia A 24-year-old man with severe aplastic anemia was treated by
chemoradiotherapy consisting of cyclophospamide and total lymphoid irradiation, and irradiation, and transplantation. Of bone marrow (BMT) collected from his HLA identical sister. Trilineage engraftment was documented on day 19 From day 39
progressive
thrombocytopenia was developed, and followed by neutropenia to absoluse granulocyte count less than 500/㎣ without evidence of acute graft-versus-host disease From day 74, rhGM-CSF was administered by subcutaneous injection at dose of 3 ㎍/kg
under
the
impression of late graft failure. The patient reached an absolute granulocyte count≥7,000/㎣ within 2 weeks of starting GM-CSF, without significant side effects, and exacerbation of graft-versus-host disease. After stopping GM-CSF, his
neutrophls
and
platelet were normalized and maintained for at least 3 months.
In conclusion, in view of the poor prognosis of patients with graft failure after bone marrow transplantation and the lack of alternative effective therapy, the present data suggest that patients with marrow graft failure should receive a trial
of
rhGM-CSF.
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KEYWORD
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