Cyclosporine and graft failure following bone marrow transplantation for severe aplastic anaemia.

Thirty-nine patients with severe aplastic anaemia were transplanted from HLA identical sibling donors. Irradiation was not used in the pre-transplant immunosuppressive protocol and cyclosporine was used as the post graft immunosuppressive agent. The incidence of primary graft failure (no take) was low occurring in 3/38 evaluable patients. Late graft failure 4-7.5 months post BMT occurred in five patients and was associated with withdrawal of cyclosporine therapy. Mixed lymphocyte chimaerism was demonstrated in 3/5 cases at the time of late graft failure and subsequent marrow recovery was autologous in four patients. Mortality from graft failure was low with 2/38 evaluable patients (5%) dying from this complication.