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Immunosuppressive therapy versus haploidentical transplantation in adults with acquired severe aplastic anemia.
Bone Marrow Transplant. 2019 08; 54(8):1319-1326.BM

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.

Authors+Show Affiliations

Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.Guangzhou First People's Hospital, Guangzhou, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.Guangzhou First People's Hospital, Guangzhou, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.Guangzhou First People's Hospital, Guangzhou, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.Guangzhou First People's Hospital, Guangzhou, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. Peking-Tsinghua Center for Life Sciences, Beijing, China.Guangzhou First People's Hospital, Guangzhou, China.Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China. lpxu_0415@sina.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30670825

Citation

Xu, Zheng-Li, et al. "Immunosuppressive Therapy Versus Haploidentical Transplantation in Adults With Acquired Severe Aplastic Anemia." Bone Marrow Transplantation, vol. 54, no. 8, 2019, pp. 1319-1326.
Xu ZL, Zhou M, Jia JS, et al. Immunosuppressive therapy versus haploidentical transplantation in adults with acquired severe aplastic anemia. Bone Marrow Transplant. 2019;54(8):1319-1326.
Xu, Z. L., Zhou, M., Jia, J. S., Mo, W. J., Zhang, X. H., Zhang, Y. P., Wang, Y., Li, Y. M., Huang, X. J., Wang, S. Q., & Xu, L. P. (2019). Immunosuppressive therapy versus haploidentical transplantation in adults with acquired severe aplastic anemia. Bone Marrow Transplantation, 54(8), 1319-1326. https://doi.org/10.1038/s41409-018-0410-3
Xu ZL, et al. Immunosuppressive Therapy Versus Haploidentical Transplantation in Adults With Acquired Severe Aplastic Anemia. Bone Marrow Transplant. 2019;54(8):1319-1326. PubMed PMID: 30670825.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunosuppressive therapy versus haploidentical transplantation in adults with acquired severe aplastic anemia. AU - Xu,Zheng-Li, AU - Zhou,Ming, AU - Jia,Jin-Song, AU - Mo,Wen-Jian, AU - Zhang,Xiao-Hui, AU - Zhang,Yu-Ping, AU - Wang,Yu, AU - Li,Yu-Miao, AU - Huang,Xiao-Jun, AU - Wang,Shun-Qing, AU - Xu,Lan-Ping, Y1 - 2019/01/22/ PY - 2018/05/13/received PY - 2018/11/10/accepted PY - 2018/11/08/revised PY - 2019/1/24/pubmed PY - 2020/8/13/medline PY - 2019/1/24/entrez SP - 1319 EP - 1326 JF - Bone marrow transplantation JO - Bone Marrow Transplant. VL - 54 IS - 8 N2 - 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. SN - 1476-5365 UR - https://www.unboundmedicine.com/medline/citation/30670825/Immunosuppressive_therapy_versus_haploidentical_transplantation_in_adults_with_acquired_severe_aplastic_anemia_ L2 - http://dx.doi.org/10.1038/s41409-018-0410-3 DB - PRIME DP - Unbound Medicine ER -