Successful allogeneic bone marrow transplantation in a 6.5-year-old male for severe aplastic anemia complicating orthotopic liver transplantation for fulminant non-A-non-B hepatitis.

We report the case of a 6.5-year-old male who received an unrelated orthotopic liver transplant for hepatic failure and encephalopathy following non-A-non-B hepatitis and subsequently developed severe aplastic anemia. For treatment of his aplastic anemia, he received a successful marrow transplant from his 9-year-old genotypically HLA-identical sister following conditioning with cyclophosphamide 200 mg/kg and anti-thymocyte globulin 90 mg/kg. Significant veno-occlusive disease of the liver and graft-versus-host disease did not occur. The patient remains alive without clinical chronic active hepatitis or need for blood product therapy. His hematocrit is 36%, white blood cell count 9.7 x 10(3)/mm3, and platelet count 1.7 x 10(5)/mm3 almost 2 years after marrow transplantation.

[1]  S. Nimer,et al.  Successful treatment of hepatic venoocclusive disease in a bone marrow transplant patient with orthotopic liver transplantation. , 1990, Transplantation.

[2]  H. Deeg,et al.  Graft‐versus‐host disease prevention by methotrexate combined with cyclosporin compared to methotrexate alone in patients given marrow grafts for severe aplastic anaemia: long‐term follow‐up of a controlled trial , 1989, British journal of haematology.

[3]  T. Starzl,et al.  Aplastic anemia after liver transplantation for non-A, non-B hepatitis. , 1989, The New England journal of medicine.

[4]  M. Deierhoi,et al.  Use of cryopreserved donor bone marrow in cadaver kidney allograft recipients. , 1989, Transplantation proceedings.

[5]  F. Appelbaum,et al.  Regimen-related toxicity in patients undergoing bone marrow transplantation. , 1988, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  E. Gluckman,et al.  Bone marrow transplantation (BMT) versus immunosuppression for the treatment of severe aplastic anaemia (SAA): a report of the EBMT * SAA Working Party , 1988, British journal of haematology.

[7]  P. Stock,et al.  Aplastic anemia complicating orthotopic liver transplantation for non-A, non-B hepatitis. , 1988, The New England journal of medicine.

[8]  D. V. van Thiel,et al.  Liver transplantation: An overview , 1988, Hepatology.

[9]  S. Chamaret,et al.  FATAL ACUTE HIV INFECTION WITH APLASTIC ANAEMIA, TRANSMITTED BY LIVER GRAFT , 1988, The Lancet.

[10]  D. Samuel,et al.  Emergency liver transplantation for fulminant hepatitis. , 1987, Annals of internal medicine.

[11]  K. Sullivan,et al.  Second marrow transplants in patients with aplastic anemia rejecting the first graft: use of a conditioning regimen including cyclophosphamide and antithymocyte globulin. , 1987, Blood.

[12]  H. Deeg,et al.  Marrow graft rejection and veno-occlusive disease of the liver in patients with aplastic anemia conditioned with cyclophosphamide and cyclosporine. , 1986, Transplantation.

[13]  H. Deeg,et al.  Marrow transplantation for severe aplastic anemia. Long-term outcome in fifty "untransfused" patients. , 1986, Annals of internal medicine.

[14]  R. Storb,et al.  Bone marrow transplantation experience for children with aplastic anemia. , 1986, Pediatrics.

[15]  K. Sullivan,et al.  Marrow transplantation in hepatitis‐associated aplastic anemia , 1984, American journal of hematology.

[16]  A. Gratwohl,et al.  Liver transplantation followed by high-dose cyclophosphamide, total-body irradiation, and autologous bone marrow transplantation for treatment of metastatic breast cancer. A case report. , 1984, Transplantation.

[17]  H. Deeg,et al.  Marrow transplantation for aplastic anemia. , 1974, Seminars in hematology.

[18]  Pankaj Sharma,et al.  Venocclusive Disease of the Liver after Bone Marrow Transplantation: Diagnosis, Incidence, and Predisposing Factors , 1984, Hepatology.

[19]  K. Sullivan,et al.  Allogeneic marrow transplantation. , 1984, Cancer investigation.

[20]  J. Dienstag.  Non-A, non-B hepatitis. I. Recognition, epidemiology, and clinical features , 1983 .

[21]  R. Storb,et al.  Aplastic anemia (first of two parts): pathogenesis, diagnosis, treatment, and prognosis. , 1982 .

[22]  K. Sullivan,et al.  Marrow transplantation with or without donor buffy coat cells for 65 transfused aplastic anemia patients , 1982 .

[23]  Kristine,et al.  Marrow transplantation with or without donor buffy coat cells for 65 transfused aplastic anemia patients. , 1982, Blood.

[24]  K. Kopecky,et al.  An analysis of hepatic venocclusive disease and centrilobular hepatic degeneration following bone marrow transplantation. , 1980, Gastroenterology.

[25]  B. Camitta.  The role of viral infections in aplastic anemia. , 1979, Haematology and blood transfusion.

[26]  G. Gitnick,et al.  Vigorous medical management of acute fulminant hepatitis. , 1977, Archives of internal medicine.

[27]  L. Hagler,et al.  Aplastic anemia following viral hepatitis: report of two fatal cases and literature review. , 1975, Medicine.

[28]  D. Nathan,et al.  Posthepatitic severe aplastic anemia--an indication for early bone marrow transplantation. , 1974, Blood.

[29]  R. Storb,et al.  Effect of prior blood transfusions on marrow grafts: abrogation of sensitization by procarbazine and antithymocyte serum. , 1974, Journal of immunology.

[30]  G. L. Floersheim.  INDUCTION OF UNRESPONSIVENESS TO SKIN AND HEART ALLOGRAFTS IN MICE BY A SYNERGISTIC TREATMENT WITH PROCARBAZINE, ANTILYMPHOCYTE SERUM, AND DONOR-TYPE CELLS , 1973, Transplantation.

[31]  T E Starzl,et al.  Liver transplantation. , 1967, Bulletin de la Societe internationale de chirurgie.