Autoimmunity and Its Treatment in Aplastic Anemia

Editorials15 January 1997Autoimmunity and Its Treatment in Aplastic AnemiaNeal S. Young, MDNeal S. Young, MDNational Heart, Lung, and Blood Institute, Bethesda, MD 20892Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-2-199701150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A century ago, long before much was understood about blood cell production, astute clinicians inferred from the fatty bone marrow of their patients who had died of aplastic anemia a fundamental failure of hematopoiesis [1]. This conclusion has been fully confirmed by modern laboratory testing, including flow cytometric measurements of primitive blood cells that bear the CD34 antigen and tissue culture assays for progenitor and stem cells [2]. Severe aplastic anemia, which is characterized by profound depression of neutrophil, platelet, and erythrocyte counts, could not be effectively treated until bone marrow transplantation was developed in the 1970s. An adequate inoculum ...References1. Vaquez MH, Aubertin C. L'anemie pernicieuse d'apres les conceptions actuelles. Bulletins et Memoires de la Societe Medicale des Hopitaux de Paris. 1904; 21:288-97. Google Scholar2. Maciejewski JP, Selleri C, Sato T, Anderson SA, Young NS. A severe and consistent deficit in marrow and circulating primitive hematopoietic cells (long-term culture-initiating cells) in acquired aplastic anemia. Blood. 1996; 88:1983-91. Google Scholar3. Champlin RE, Feig SA, Sparkes RS, Galen RP. Bone marrow transplantation from identical twins in the treatment of aplastic anaemia: implication for the pathogenesis of the disease. Br J Haematol. 1984; 56:455-63. Google Scholar4. 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European Bone Marrow Transplantation-Severe Aplastic Anaemia Working Party. N Engl J Med. 1993; 329:1152-7. Google Scholar20. Champlin RE, Horowitz MM, van Bekkum DW, Camitta BM, Elfenbein GE, Gale RP, et al. Graft failure following bone marrow transplantation for severe aplastic anemia: risk factors and treatment results. Blood. 1989; 73:606-13. Google Scholar21. Crump M, Larratt LM, Maki E, Curtis JE, Minden MD, Meharchand JM, et al. Treatment of adults with severe aplastic anemia: primary therapy with antithymocyte globulin (ATG) and rescue of ATG failures with bone marrow transplantation. Am J Med. 1992; 92:596-602. Google Scholar22. Brodsky RA, Sensenbrenner LL, Jones RJ. Complete remission in severe aplastic anemia after high-dose cyclophosphamide without bone marrow transplantation. Blood. 1996; 87:491-4. Google Scholar Author, Article, and Disclosure InformationAffiliations: National Heart, Lung, and Blood Institute, Bethesda, MD 20892Corresponding Author: Neal S. Young, MD, National Heart, Lung, and Blood Institute, Building 10, Room 7C103, 9000 Rockville Pike, Bethesda, MD 20892-1652. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrimary Treatment of Acquired Aplastic Anemia: Outcomes with Bone Marrow Transplantation and Immunosuppressive Therapy Kristine Doney , Wendy Leisenring , Rainer Storb , and Frederick R. Appelbaum Results of Transplanting Bone Marrow from Genetically Identical Twins into Patients with Aplastic Anemia Wolfgang Hinterberger , Philip A. Rowlings , Margareta Hinterberger-Fischer , John Gibson , Niels Jacobsen , John P. Klein , Hans-Jochem Kolb , Don A. Stevens , Mary M. Horowitz , and Robert Peter Gale Metrics Cited ByModel-Based Determination of Effective Blood Concentrations of Cyclosporine for Neutrophil Response in the Treatment of Severe Aplastic Anemia in ChildrenAbnormal quantity and function of regulatory T cells in peripheral blood of patients with severe aplastic anemiaAntithymocyte globulin combined with cyclosporine A down-regulates T helper 1 cells by modulating T cell immune response cDNA 7 in aplastic anemiaAbnormalities of quantities and functions of linker for activations of T cells in severe aplastic anemiaSalvage therapy of refractory severe aplastic anemia by decreasing cyclosporine dose regimenA hospital-based case control study of aplastic anemia in Shanghai, ChinaTreatment strategies for patients with severe aplastic anemiaDeficient CD4+ CD25+ FOXP3+ T regulatory cells in acquired aplastic anemiaImmunosuppressive therapy for acquired severe aplastic anemia (SAA): A prospective comparison of four different regimensT-bet, a Th1 transcription factor, is up-regulated in T cells from patients with aplastic anemiaAplastic AnemiaCyclosporine monotherapy for severe aplastic anemia: a developing country experienceT-cell suppression mediated by mesenchymal stem cells is deficient in patients with severe aplastic anemiaSuccessful allogeneic hematopoietic stem cell transplantation using triple agent immunosuppression in severe aplastic anemia patientsRupturedKlebsiella pneumoniae liver abscess after high-dose cyclophosphamide for severe aplastic anemiaCurrent status of allogeneic bone marrow transplantation in acquired aplastic anemiaImmunoablative high-dose cyclophosphamide without stem cell rescue in paraneoplastic pemphigus: Report of a case and review of this new therapy for severe autoimmune diseaseExpression of interferon-γ by stromal cells inhibits murine long-term repopulating hematopoietic stem cell activityAplastische Anämie (Panmyelopathie) und verwandte HämozytopenienRepeated treatment with horse antilymphocyte globulin for severe aplastic anaemia 15 January 1997Volume 126, Issue 2Page: 166-168KeywordsAntigensAplastic anemiaBlood cellsBone marrowCellsGlobulinsImmune systemImmunosuppressivesLymphocytesTransplantation Issue Published: 15 January 1997 CopyrightCopyright © 1997 by American College of Physicians. 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