Advertisement

Bone marrow transplantation in thalassemia

Chapter
Part of the Cancer Treatment and Research book series (CTAR, volume 77)

Abstract

Thalassemia refers to various types of hereditary anemias identified by a reduced production of one of the globin chains that form the hemoglobin molecule [1]. In β-thalassemia, there is a deficient or absent synthesis of β-globin chains that constitute the adult hemoglobin molecule, which causes several deleterious effects on erythrocyte production and survival. Hemolysis and ineffective erythropoiesis lead to a chronic anemia with erythroid marrow hyperplasia; this determines an increase in the plasma iron turnover and, consequently, increased iron absorption. A progressive iron overload is associated with the above mechanism and is the consequence of the red cell transfusional regimen adopted to correct the anemia. Transfusions and regular iron chelation with deferoxamine constitute the conventional treatment for severe β-thalassemia. Homozygous thalassemia, which once resulted in early death, has become a chronic disease compatible with prolonged survival [2,3], although it remains a progressive disease.

Keywords

Iron Overload Acute GVHD Chronic GVHD Allogeneic Bone Marrow Transplantation Thalassemic Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Weatherall DJ, Clegg JG. The Thalassemia Syndromes. Oxford: Blackwell Scientific Publications, 1981, pp. 744–782.Google Scholar
  2. 2.
    Piomelli S, Loew T. Management of thalassemia major (Cooley’s anemia). Hematol Oncol Clin North Am 5:557–560, 1991.PubMedGoogle Scholar
  3. 3.
    Modell B, Letsky EA, Flynn DM, et al. Survival and desferrioxamine in thalassemia major. Br Med J 284:1081–1084, 1982.CrossRefGoogle Scholar
  4. 4.
    Thomas ED, Buckner CD, Sanders JE, et al. Marrow transplantation for thalassemia. Lancet 2:227–229, 1982.PubMedGoogle Scholar
  5. 5.
    Lucarelli G, Izzi T, Polchi P, et al. Bone marrow transplantation in thalassemia. J Exp Clin Cancer Res 3:313–315, 1983.Google Scholar
  6. 6.
    Lucarelli G, Polchi P, Izzi T, et al. Allogeneic marrow transplantation for thalassemia. Exp Hematol 12:676–681, 1984.PubMedGoogle Scholar
  7. 7.
    Santos GW, Tutschka PJ, Brookmeyer R, et al. Marrow transplantation for acute nonlymphocytic leukemia after treatment with busulfan and cyclophosphamide. N Engl J Med 309:1347–1353, 1983.PubMedCrossRefGoogle Scholar
  8. 8.
    Lucarelli G, Polchi P, Galimberti M, et al. Marrow transplantation for thalassemia following busulfan and cyclophosphamide. Lancet 1:1355–1357, 1985.PubMedCrossRefGoogle Scholar
  9. 9.
    Lucarelli G, Galimberti M, Polchi P, et al. Bone marrow transplantation in advanced thalassemia. N Engl J Med 316:1050–1055, 1987.PubMedCrossRefGoogle Scholar
  10. 10.
    Lucarelli G, Galimberti M, Polchi P, et al. Bone marrow transplantation in patients with thalassemia. N Engl J Med 322:417–421, 1990.PubMedCrossRefGoogle Scholar
  11. 11.
    Lucarelli G, Galimberti M, Polchi P, et al. Bone marrow transplantation in thalassemia. Hematol Oncol Clin North Am 5:549–556, 1991.PubMedGoogle Scholar
  12. 12.
    Lucarelli G, Galimberti M, Polchi P, et al. Marrow transplantation in patients with thalassemia responsive to iron chelation therapy. N Engl J Med 329:840–844, 1993.PubMedCrossRefGoogle Scholar
  13. 13.
    Muretto P, Angelucci E, Del Fiasco S, et al. Reversal feature of hepatic haemodisderosis and aemochromatiosis in thalassemia after bone marrow transplantation. In Buckner CD, Gale RP, Lucarelli G (eds), Advances and Controversies in Thalassemia Therapy: Bone Marrow Transplantation and Other Approaches. Prog Clin Biol Res 309:299–314, 1989.PubMedGoogle Scholar
  14. 14.
    Muretto P, Del Fiasco S, Angelucci E, et al. Bone marrow transplantation in thalassemia: modifications of hepatic iron overload and associated lesions after long-term engrafting. Liver 14:14–24, 1994.PubMedCrossRefGoogle Scholar
  15. 15.
    Tutschka PJ, Copelan EA, Kapoor N. Bone marrow transplantation for leukemia following a new busulfan and cyclophosphamide regimen. Blood 70:1382–1388, 1987.PubMedGoogle Scholar
  16. 16.
    Lucarelli G, Galimberti M, Polchi P, et al. Bone marrow transplantation in adult thalassemia. Blood 80:1603–1607, 1992.PubMedGoogle Scholar
  17. 17.
    Angelucci E, Mariotti E, Lucarelli G, et al. Sudden cardiac tamponade after chemotherapy for marrow transplantation in thalassemia. Lancet 339:287–289, 1992.PubMedCrossRefGoogle Scholar
  18. 18.
    Weatherall DJ. Bone marrow transplantation for thalassemia and other inherited disorders of hemogloin (editorial). Blood 80:1379–1381, 1992.PubMedGoogle Scholar
  19. 19.
    Di Bartolomeo P, Di Girolamo G, Agrilli F, et al. Treatment of thalassemia by allogeneic bone marrow transplantation. Bone Marrow Transplant 12(Suppl 1):37–41, 1993.PubMedGoogle Scholar
  20. 20.
    Lin KH, Linn KS. Allogeneic bone marrow transplantation for thalassemia in Taiwan: factors associated with graft failure. Am J Pediatr Hematol Oncol 11:417–420, 1989.PubMedGoogle Scholar
  21. 21.
    Frappaz D. Allogeneic bone marrow graft in thalassemia major. The French Experience. Arch Fra Pediatr 47:97–100, 1990.Google Scholar
  22. 22.
    Issagrilis S, Visudhisakchai S, Suvatte V, et al. Bone marrow transplantation for thalassemia in Thailand. Bone Marrow Transplant 12(Suppl 1):42–44, 1993.Google Scholar
  23. 23.
    Contu L, La Nasa G, Pizzati A, et al. Bone marrow transplantation in thalassemia. The Cagliari team experience. Bone Marrow Transplant 12(Suppl 1):45–46, 1993.PubMedGoogle Scholar
  24. 24.
    Walters MC, Thomas ED. Bone marrow transplantation for thalassemia: the United States experience. Am J Pediatr Hematol Oncol 16:11–17, 1994.PubMedGoogle Scholar
  25. 25.
    Vellodi A, Picton S, Downie CJC, et al. Bone marrow transplantation for thalassemia: experience of two British centers. Bone Marrow Transplant 13:559–562, 1994.PubMedGoogle Scholar
  26. 26.
    Nathan DG, Oski FA. Hematology of infancy and childhood, vol. 1, 4th ed. Philadelphia: WB Saunders, 1993, p. 845.Google Scholar
  27. 27.
    Ehlers KH, Giardina PJ, Lesser ML, et al. Prolonged survival in patients with beta-thalassemia major treated with deferoxamine. Pediatr 118:540–545, 1991.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

There are no affiliations available

Personalised recommendations