Recent improvement in outcome of unrelated donor transplantation for aplastic anemia
- 5 November 2007
- journal article
- Published by Springer Science and Business Media LLC in Bone Marrow Transplantation
- Vol. 41 (1), 45-50
- https://doi.org/10.1038/sj.bmt.1705894
Abstract
The aim was to determine whether outcome of unrelated donor transplantation for severe aplastic anemia has improved in recent years and whether this is due to patient selection or better transplant technology. We analyzed 498 patients transplanted during 1990-2005. By running univariate regression models dichotomizing year of transplantation we defined 1998 as the year of the most significant change in survival. Five-year survival increased from 32+/-8% before 1998 to 57+/-8% after 1998 (P<0.0001). When comparing the cohort before (n=149) and after 1998 (n=349), there were no differences except for older age, and more frequent use of PBSCs, after 1998. High-resolution HLA typing data were unavailable. After 1998, there was less graft failure (11 vs 26%, P<0.0001), less acute GvHD (cumulative incidence 28 vs 37%, P=0.02) and less chronic GvHD (22 vs 38%, P=0.004). In multivariate analyses adjusting for differences in age, HLA-mismatch, performance score and time to transplantation, there was no change in the year of transplant effect (relative risk of death in transplants after 1998: 0.44 (95% confidence interval 0.33-0.59)). There is no evidence for patient selection to explain significantly improved survival in patients transplanted after 1998. We speculate that this is due to better donor matching.Keywords
This publication has 29 references indexed in Scilit:
- Bone marrow transplantation for severe aplastic anemia: a randomized controlled study of conditioning regimensBlood, 2007
- Outcome of patients with acquired aplastic anemia given first line bone marrow transplantation or immunosuppressive treatment in the last decade: a report from the European Group for Blood and Marrow TransplantationHaematologica, 2007
- Current concepts in the pathophysiology and treatment of aplastic anemiaBlood, 2006
- Bone marrow transplants from mismatched related and unrelated donors for severe aplastic anemiaBone Marrow Transplantation, 2006
- Long-term outcome after bone marrow transplantation for severe aplastic anemiaBlood, 2004
- Guidelines for the diagnosis and management of acquired aplastic anaemiaBritish Journal of Haematology, 2003
- Treatment of acquired severe aplastic anemia: Bone marrow transplantation compared with immunosuppressive therapy-the European group for blood and marrow transplantation experienceSeminars in Hematology, 2000
- BONE MARROW TRANSPLANTATION FOR SEVERE APLASTIC ANEMIA FROM GENOTYPICALLY HLA-NONIDENTICAL RELATIVESTransplantation, 1996
- Bone marrow transplantation for aplastic anaemia from a HL-A and MLC-identical unrelated donorBlut: Zeitschrift für die Gesamte Blutforschung, 1975
- ALLOGENEIC BONE MARROW TRANSPLANTATION IN A PATIENT WITH APLASTIC ANEMIA USING A PHENOTYPICALLY HL-A-IDENTICAL UNRELATED DONORTransplantation, 1973