02595nas a2200253   4500008004100000020001400041024001700055245015700072210006900229260025700298300001600555490000700571520153700578100002302115700002002138700001802158700002002176700002202196700001802218700001902236700002302255700001802278856004502296       2002                        eng d  a0041-1132  awdn, 041736000aEarly diagnosis and successful treatment of a patient with transfusion-associated GVHD with autologous peripheral blood progenitor cell transplantation.0 aEarly diagnosis and successful treatment of a patient with trans  a(C) 2002 Blackwell Science Ltd.bDivision of Hematology Oncology, University of California-Davis School of Medicine, Davis; Sacramento Medical Foundation Blood Center, Sacramento; VA Northern California Health Care System, Sacramento, California.c2002  a1567 - 15720 v423 aBACKGROUND: Transfusion-associated GVHD (TA-GVHD) is an uncommon complication of blood transfusion. Diagnosis of TA-GVHD is difficult, and it is usually rapidly fatal. There are few documented sur-vivors of TA-GVHD., CASE REPORT: A 61-year-old woman with chronic lymphocytic leukemia (CLL) was treated with fludarabine followed by combination chemotherapy and high-dose radioimmunotherapy and peripheral blood progenitor cell (PBPC) rescue. She was transfused with nonirradiated blood components at an outside hospital and presented 10 days later with rash, elevated liver enzymes, and progressive pancytopenia. Skin biopsy was consistent with GVHD, and HLA typing of lymphocytes from the patient demonstrated mixed chimerism. The patient was treated with solumedrol and cyclosporin A, followed by high-dose cyclophosphamide and antithymocyte globulin and autologous PBPC infusion. She had rapid engraftment, resolution of skin rash, and normalization of liver function abnormalities. She is in good health with normal blood counts and no evidence of CLL 34 months after transplantation., CONCLUSION: TA-GVHD occurs in the setting of an immunocompromised recipient receiving nonirradiated blood components. A typical presentation includes skin rash, liver function abnormalities, and pancytopenia. Demonstration of mixed chimerism by HLA typing facilitated diagnosis in this patient. High-dose immunosuppression, facilitated by the availability of autologous PBPCs, resulted in a successful outcome., (C) 2002 Blackwell Science Ltd.1 aHutchinson, Kendra1 aKopko, Patricia1 aMuto, Kathryn1 aTuscano, Joseph1 aO'Donnell, Robert1 aHolland, Paul1 aRichman, Carol1 aPaglieroni, Teresa1 aWun, Theodore  uhttp://613633.bywedr.asia/reference/4217