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What Causes Aplastic Anaemia: Results of Transplants from Genetically-Identical Twins

BACKGROUND: Aplastic anaemia has diverse aetiologies. Distinguishing between these is, in part, testable by analyzing results of haematopoietic cells transplants between genetically-identical twins one of whom has aplastic anaemia. OBJECTIVE: Describe outcomes of genetically-identical twin transplan...

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Autores principales: Gale, Robert, Hinterberger, Wolfgang, Young, Neal S., GENNERY, Andrew, Dvorak, Christopher, Hebert, Kyle, Heim, Michael, Broglie, Larisa, Eapen, Mary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Journal Experts 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9915784/
https://www.ncbi.nlm.nih.gov/pubmed/36778326
http://dx.doi.org/10.21203/rs.3.rs-2540187/v1
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author Gale, Robert
Hinterberger, Wolfgang
Young, Neal S.
GENNERY, Andrew
Dvorak, Christopher
Hebert, Kyle
Heim, Michael
Broglie, Larisa
Eapen, Mary
author_facet Gale, Robert
Hinterberger, Wolfgang
Young, Neal S.
GENNERY, Andrew
Dvorak, Christopher
Hebert, Kyle
Heim, Michael
Broglie, Larisa
Eapen, Mary
author_sort Gale, Robert
collection PubMed
description BACKGROUND: Aplastic anaemia has diverse aetiologies. Distinguishing between these is, in part, testable by analyzing results of haematopoietic cells transplants between genetically-identical twins one of whom has aplastic anaemia. OBJECTIVE: Describe outcomes of genetically-identical twin transplants for aplastic anaemia with and without pretransplant conditioning. METHODS: We interrogated data from an observational database of 59 consecutive recipients of genetically-identical twin transplants for aplastic anaemia reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) 2000–2019. RESULTS: 38 subjects were male. Median age was 18 years (Interquartile Range [IQR], 11–32 years). Median interval from diagnosis to transplant was 2 months (IQR 1–3 months). 11 subjects received a 1(st) transplant without pretransplant conditioning. 2 of recovered normal bone marrow function. The other 9 received a 2(nd) transplant with pretransplant conditioning 7 of whom recovered. 48 subjects received pretransplant conditioning before a 1(st) or 2(nd) transplant all of whom recovered. CONCLUSION: Only some genetically-identical twins with aplastic anaemia recover normal bone marrow function after a 1(st) haematopoietic cell transplant without pretransplant conditioning whereas most subjects recover when a transplant is preceded by pretransplant conditioning. These data are consistent with an immune-mediated aetiology of aplastic anaemia in most cases.
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spelling pubmed-99157842023-02-11 What Causes Aplastic Anaemia: Results of Transplants from Genetically-Identical Twins Gale, Robert Hinterberger, Wolfgang Young, Neal S. GENNERY, Andrew Dvorak, Christopher Hebert, Kyle Heim, Michael Broglie, Larisa Eapen, Mary Res Sq Article BACKGROUND: Aplastic anaemia has diverse aetiologies. Distinguishing between these is, in part, testable by analyzing results of haematopoietic cells transplants between genetically-identical twins one of whom has aplastic anaemia. OBJECTIVE: Describe outcomes of genetically-identical twin transplants for aplastic anaemia with and without pretransplant conditioning. METHODS: We interrogated data from an observational database of 59 consecutive recipients of genetically-identical twin transplants for aplastic anaemia reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) 2000–2019. RESULTS: 38 subjects were male. Median age was 18 years (Interquartile Range [IQR], 11–32 years). Median interval from diagnosis to transplant was 2 months (IQR 1–3 months). 11 subjects received a 1(st) transplant without pretransplant conditioning. 2 of recovered normal bone marrow function. The other 9 received a 2(nd) transplant with pretransplant conditioning 7 of whom recovered. 48 subjects received pretransplant conditioning before a 1(st) or 2(nd) transplant all of whom recovered. CONCLUSION: Only some genetically-identical twins with aplastic anaemia recover normal bone marrow function after a 1(st) haematopoietic cell transplant without pretransplant conditioning whereas most subjects recover when a transplant is preceded by pretransplant conditioning. These data are consistent with an immune-mediated aetiology of aplastic anaemia in most cases. American Journal Experts 2023-02-03 /pmc/articles/PMC9915784/ /pubmed/36778326 http://dx.doi.org/10.21203/rs.3.rs-2540187/v1 Text en https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) , which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use. https://creativecommons.org/licenses/by/4.0/License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Article
Gale, Robert
Hinterberger, Wolfgang
Young, Neal S.
GENNERY, Andrew
Dvorak, Christopher
Hebert, Kyle
Heim, Michael
Broglie, Larisa
Eapen, Mary
What Causes Aplastic Anaemia: Results of Transplants from Genetically-Identical Twins
title What Causes Aplastic Anaemia: Results of Transplants from Genetically-Identical Twins
title_full What Causes Aplastic Anaemia: Results of Transplants from Genetically-Identical Twins
title_fullStr What Causes Aplastic Anaemia: Results of Transplants from Genetically-Identical Twins
title_full_unstemmed What Causes Aplastic Anaemia: Results of Transplants from Genetically-Identical Twins
title_short What Causes Aplastic Anaemia: Results of Transplants from Genetically-Identical Twins
title_sort what causes aplastic anaemia: results of transplants from genetically-identical twins
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9915784/
https://www.ncbi.nlm.nih.gov/pubmed/36778326
http://dx.doi.org/10.21203/rs.3.rs-2540187/v1
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