Allogeneic stem cell transplantation for severe aplastic anemia: graft rejection remains a problem

Transfus Apher Sci. 2009 Feb;40(1):5-11. doi: 10.1016/j.transci.2008.11.007. Epub 2009 Jan 3.

Abstract

We reviewed the outcome in 15 consecutive patients with severe aplastic anemia with a median age of 23 years who received matched sibling peripheral blood stem cell transplantation. Conditioning regimen was cyclophosphamide (Cy)+anti-thymocyte globulin (ATG). Cumulative incidence of transplant related mortality, graft failure, acute and chronic GVHD were 20%, 33%, 25%, and 8.3%, respectively. Conditioning with Cy only, resulted in higher rejection rate compared to Cy plus ATG (75% versus 12.5%, p=0.03). Eighty percent of patients are alive with a median follow-up of 19.5 (4.6-35.6) months. Two of the three patients who were re-transplanted with fludarabine had sustained donor chimerism.

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Aplastic / mortality*
  • Anemia, Aplastic / therapy*
  • Antilymphocyte Serum / administration & dosage
  • Cyclophosphamide / administration & dosage
  • Disease-Free Survival
  • Female
  • Graft Rejection / mortality*
  • Graft Rejection / therapy
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Male
  • Myeloablative Agonists / administration & dosage
  • Peripheral Blood Stem Cell Transplantation*
  • Survival Rate
  • Transplantation Conditioning*
  • Transplantation, Homologous

Substances

  • Antilymphocyte Serum
  • Immunosuppressive Agents
  • Myeloablative Agonists
  • Cyclophosphamide