Effect of stem cell source on outcomes after unrelated donor transplantation in severe aplastic anemia

被引：112

作者：

Eapen, Mary ^{[1
]}

Le Rademacher, Jennifer ^{[1
]}

Antin, Joseph H. ^{[2
]}

Champlin, Richard E. ^{[3
]}

Carreras, Jeanette ^{[1
]}

Fay, Joseph ^{[4
]}

Passweg, Jakob R. ^{[5
]}

Tolar, Jakub ^{[6
]}

Horowitz, Mary M. ^{[1
]}

Marsh, Judith C. W. ^{[7
]}

Deeg, H. Joachim ^{[8
]}

机构：

[1] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA

[2] Dana Farber Canc Inst, Boston, MA 02115 USA

[3] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA

[4] Baylor Univ, Med Ctr, Dallas, TX USA

[5] Univ Basel, Basel, Switzerland

[6] Univ Minnesota, Minneapolis, MN USA

[7] Kings Coll London, London WC2R 2LS, England

[8] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA

来源：

BLOOD | 2011年 / 118卷 / 09期

关键词：

MARROW TRANSPLANTATION; PATHOPHYSIOLOGY; GVHD;

D O I：

10.1182/blood-2011-05-354001

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Outcome after unrelated donor bone marrow (BM) transplantation for severe aplastic anemia (SAA) has improved, with survival rates now approximately 75%. Increasing use of peripheral blood stem and progenitor cells (PBPCs) instead of BM as a graft source prompted us to compare outcomes of PBPC and BM transplantation for SAA. We studied 296 patients receiving either BM (n = 225) or PBPC (n = 71) from unrelated donors matched at human leukocyte antigen-A, -B, -C, -DRB1. Hematopoietic recovery was similar after PBPC and BM transplantation. Grade 2 to 4 acute graft-versus-host disease risks were higher after transplantation of PBPC compared with BM (hazard ratio = 1.68, P = .02; 48% vs 31%). Chronic graft-versus-host disease risks were not significantly different after adjusting for age at transplantation (hazard ratio = 1.39, P = .14). Mortality risks, independent of age, were higher after PBPC compared with BM transplantation (hazard ratio = 1.62, P = .04; 76% vs 61%). These data indicate that BM is the preferred graft source for unrelated donor transplantation in SAA. (Blood. 2011; 118(9):2618-2621)

引用

页码：2618 / 2621

页数：4

共 14 条

[1]

Bacigalupo A, 2010, BLOOD, V116, P231

[2]

COX DR, 1972, J R STAT SOC B, V34, P187

[3] Optimization of conditioning for marrow transplantation from unrelated donors for patients with aplastic anemia after failure of immunosuppressive therapy [J].

Deeg, H. Joachim ;

O'Donnell, Margaret ;

Tolar, Jakub ;

Agarwal, Rajni ;

Harris, Richard E. ;

Feig, Stephen A. ;

Territo, Mary C. ;

Collins, Robert H. ;

McSweeney, Peter A. ;

Copelan, Edward A. ;

Khan, Shakila P. ;

Woolfrey, Ann ;

Storer, Barry .

BLOOD, 2006, 108 (05) :1485-1491

[4] Malignancies after marrow transplantation for aplastic anemia and Fanconi anemia: A joint Seattle and Paris analysis of results in 700 patients [J].

Deeg, HJ ;

Socie, G ;

Schoch, G ;

HenryAmar, M ;

Witherspoon, RP ;

Devergie, A ;

Sullivan, KM ;

Gluckman, E ;

Storb, R .

BLOOD, 1996, 87 (01) :386-392

[5] Pathophysiology and treatment of graft-versus-host disease [J].

Flowers, MED ;

Kansu, E ;

Sullivan, KM .

HEMATOLOGY-ONCOLOGY CLINICS OF NORTH AMERICA, 1999, 13 (05) :1091-+

[6]

Klein JP, 2003, Techniques for censored and truncated data, V2nd

[7]

Margolis DA, 2000, SEMIN HEMATOL, V37, P43

[8] Guidelines for the diagnosis and management of aplastic anaemia [J].

Marsh, Judith C. W. ;

Ball, Sarah E. ;

Cavenagh, Jamie ;

Darbyshire, Phil ;

Dokal, Inderjeet ;

Gordon-Smith, Edward C. ;

Keidan, Jane ;

Laurie, Andrew ;

Martin, Anna ;

Mercieca, Jane ;

Killick, Sally B. ;

Stewart, Rhona ;

Yin, John A. L. .

BRITISH JOURNAL OF HAEMATOLOGY, 2009, 147 (01) :43-70

[9]

PRZEPIORKA D, 1995, BONE MARROW TRANSPL, V15, P825

[10] Antithymocyte globulin and cyclosporine for severe aplastic anemia - Association between hematologic response and long-term outcome [J].

Rosenfeld, S ;

Follmann, D ;

Nunez, O ;

Young, NS .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 289 (09) :1130-1135

← 1 2 →