Abstract
A 17-year-old girl was admitted to our hospital on January 30, 1984 because of pancytopenia after acute non-A non-B hepatitis. A diagnosis of severe aplastic anemia after acute hepatitis was made from the following: granulocyte count 90/cmm, reticulocyte count 5,000/cmm, platelet count 15,000/cmm, and marked hypocellular marrow. Bolus methyl-prednisolone therapy was started. However, there was no clinical response to this therapy, and the patient devloped bacterial pneumonia and gastrointestinal bleeding. Pneumonia was improved by antibiotics with granulocyte infusions from random donors. She was conditioned for grafting with cyclophosphamide 50 mg/kg/day for 4 successive days and bone marrow cells (6.3×108 cells/kg) from her HLA A, B, C matched sister were infused.
Hematological findings were gradually improved, and her blood cell type was changed to the donor's on day 75 after BMT. On day 82, GVHD appeared and lasted 2 months. She died with sepsis on day 137 after BMT.
In addition, we studied the effects of serial sera of the patint on colony formation of normal bone marrow cells. Bivef discussion is made on inhibitory effect in relation to pathogenesis of posthepatitic aplastic anemia.
