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August 5, 1983

Successful Pregnancy After Marrow Transplantation for Severe Aplastic Anemia and Immunosuppression With Cyclosporine

Author Affiliations

From the Fred Hutchinson Cancer Research Center and the University of Washington School of Medicine, Seattle.

JAMA. 1983;250(5):647. doi:10.1001/jama.1983.03340050059032

ALLOGENEIC marrow transplantation has been used successfully for more than a decade to treat patients with severe aplastic anemia. At present, 70% to 80% of patients become long-term survivors,1,2 and most of these patients are being followed up in general medical clinics rather than at specialized institutions. Since many patients afflicted by this disease are young, any treatment must take into consideration potential long-term side effects. Although there has been concern that high doses of cyclophosphamide, most widely used to condition patients for transplantation, might affect gonadal and reproductive function, there have been some reports of normal pregnancies and normal offspring in patients after marrow transplantation.3-5 All these patients had received methotrexate after grafting as prophylaxis for graft-v-host disease. At present, however, many transplant centers are using the new immunosuppressant cyclosporine rather than methotrexate as prophylaxis of graft-v-host disease.6-8 Experience with this drug