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Aplastic Anemia and Other Bone Marrow Failure Syndromes (Paperback, Softcover reprint of the original 1st ed. 1990)
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Aplastic Anemia and Other Bone Marrow Failure Syndromes (Paperback, Softcover reprint of the original 1st ed. 1990)
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During the past decade, there have been numerous direct and
indirect scientific contributions to both the etiology and therapy
of aplastic anemia and related bone marrow failure syndromes.
Clinical observations, such as autologous bone marrow recovery
after conditioning with immunosup pressive agents for bone marrow
transplantation; failure to achieve en graftment in some identical
twins without prior immunosuppressive ther apy; and hematologic
response to immunosuppressive agents, have led to the concept of
immune-mediated etiology of acquired aplastic anemia. Such a
concept was further strengthened by laboratory findings, implicat
ing the role of activated cytotoxic T lymphocytes and abnormal
produc tion of inhibitory lymphokines. The immunologic mechanisms
may also apply to the idiosyncratic bone marrow aplasias associated
with drugs, toxic chemicals, and viruses. These agents may alter
normal cellular recog nition sites by interacting with cellular
components and result in loss of self tolerance. Immunologic
mechanisms have long been advocated in many other organ failures,
and the hemopoietic organ is no exception. It is of interest that
parallel clinical and laboratory investigations in juvenile
diabetes mellitus type I and in rodent models of this disease have
yielded results compatible with the same pathogenic mechanisms. The
infiltration of pancreatic islets by activated T lymphocytes,
functional and morphological alterations of islet cells upon
incubation with lymphokines such as gamma interferon and tumor
necrosis factor, and clinical response to cyclosporine are a few
examples."
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