Immunosuppressive therapy versus haploidentical transplantation in adults with acquired severe aplastic anemia View Full Text


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Article Info

DATE

2019-01-22

AUTHORS

Zheng-Li Xu, Ming Zhou, Jin-Song Jia, Wen-Jian Mo, Xiao-Hui Zhang, Yu-Ping Zhang, Yu Wang, Yu-Miao Li, Xiao-Jun Huang, Shun-Qing Wang, Lan-Ping Xu

ABSTRACT

Our study aimed to compare treatment outcomes between hematopoietic stem cell transplantation (HSCT) from haploidentical donors (HID) and immunosuppressive therapy (IST) in adults with acquired severe aplastic anemia (SAA). The medical records of 113 SAA adults who received IST, including rabbit ATG and cyclosporin (N = 37), or HID HSCT (N = 76) within 6 months of diagnosis at two institutions were retrospectively reviewed. Estimated 8-year overall survival (OS) was comparable between the IST and HID HSCT groups (75.6 vs. 83.7%, respectively, P = 0.328), but failure free survival (FFS) was significantly lower in IST group than HID HSCT group (38.5 vs. 83.7%, respectively, P = 0.001). Furthermore, a significant improvement in FFS was observed with HSCT over IST in patients under 40 years old. At the last follow-up, patients in HSCT group achieved better Karnofsky Performance Status (KPS) than those in IST group (100 [20-100] vs. 90 [20-100], P = 0.002). In terms of blood count, 83.1% (54/65) of patients in HSCT group showed complete recovery compared to only 38.2% (13/34) in IST group (P < 0.001). These data suggest that HID HSCT could be an effective alternative treatment option for SAA adults, and additional prospective studies are necessary. More... »

PAGES

1-8

References to SciGraph publications

  • 2017-12. Upfront haploidentical transplant for acquired severe aplastic anemia: registry-based comparison with matched related transplant in JOURNAL OF HEMATOLOGY & ONCOLOGY
  • 2014-04. Long-term outcome of HLA-haploidentical hematopoietic SCT without in vitro T-cell depletion for adult severe aplastic anemia after modified conditioning and supportive therapy in BONE MARROW TRANSPLANTATION
  • 2016-10. Impact of pretransplant red cell transfusion on outcome after allogeneic stem cell transplantation in adult patients with severe aplastic anemia in BONE MARROW TRANSPLANTATION
  • 2017-01. Immunosuppressive therapy versus alternative donor hematopoietic stem cell transplantation for children with severe aplastic anemia who lack an HLA-matched familial donor in BONE MARROW TRANSPLANTATION
  • 2014-12. Good outcome of haploidentical hematopoietic SCT as a salvage therapy in children and adolescents with acquired severe aplastic anemia in BONE MARROW TRANSPLANTATION
  • 2015-05. Haploidentical BMT and post-transplant Cy for severe aplastic anemia: a multicenter retrospective study in BONE MARROW TRANSPLANTATION
  • 2016-08. Bone marrow transplantation versus immunosuppressive therapy in patients with acquired severe aplastic anemia in INTERNATIONAL JOURNAL OF HEMATOLOGY
  • 2005-01. Quality-adjusted survival analysis shows differences in outcome after immunosuppression or bone marrow transplantation in aplastic anemia in ANNALS OF HEMATOLOGY
  • 2018-02. Unmanipulated haploidentical transplantation conditioning with busulfan, cyclophosphamide and anti-thymoglobulin for adult severe aplastic anaemia in BONE MARROW TRANSPLANTATION
  • 2012-12. A novel protocol for haploidentical hematopoietic SCT without in vitro T-cell depletion in the treatment of severe acquired aplastic anemia in BONE MARROW TRANSPLANTATION
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-018-0410-3

    DOI

    http://dx.doi.org/10.1038/s41409-018-0410-3

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30670825


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