TY - JOUR
T1 - Outcome of patients activating an unrelated donor search for severe acquired aplastic anemia
AU - Maury, Sébastien
AU - Balère-Appert, Marie-Lorraine
AU - Pollichieni, Simona
AU - Oneto, Rosi
AU - Yakoub-Agha, Ibrahim
AU - Locatelli, Franco
AU - Dalle, Jean-Hugues
AU - Lanino, Edoardo
AU - Fischer, Alain
AU - Pession, Andrea
AU - Huynh, Anne
AU - Barberi, Walter
AU - Mohty, Mohamad
AU - Risitano, Antonio
AU - Milpied, Noel
AU - Socié, Gérard
AU - Bacigalupo, Andrea
AU - Marsh, Judith
AU - Passweg, Jakob R.
PY - 2013
Y1 - 2013
N2 - Patients with severe aplastic anemia (SAA) without a sibling donor receive immunosuppressive treatment (IST) with anti-thymocyte globulin (ATG). In the case of no response to IST, a voluntary unrelated donor (VUD) search is usually started. This study analyzes the outcome of ATG-refractory SAA patients activating a VUD search. Of 179 patients, 68 had at least one HLA-A, -B, and -DR matched donor identified and underwent HSCT while 50 also with a donor were not transplanted because of early death (8), late response to IST (34), transplant refusal (1), or other (7). Conversely, 61 had no matched donor, 13 of those ultimately received a mismatched HSCT. All but one received marrow stem cells. Among patients aged <17 years, those with at least one matched donor had a significant higher 4-year survival as compared to others (79%+/- 6% versus 53%+/- 10%, P=0.01). There was also a survival advantage independent of recipient age when the donor search was initiated in the recent 2000-2005 study-period (74%+/- 6% versus 47%+/- 10%, P<0.05). In multivariate analysis, the identification of a matched VUD tended to impact favourably on survival in patients with a recent donor search (P=0.07). This study provides evidence for the use of unrelated donor HSCT in children and adults with IST-refractory SAA. Am. J. Hematol. 88:868-873, 2013. (c) 2013 Wiley Periodicals, Inc.
AB - Patients with severe aplastic anemia (SAA) without a sibling donor receive immunosuppressive treatment (IST) with anti-thymocyte globulin (ATG). In the case of no response to IST, a voluntary unrelated donor (VUD) search is usually started. This study analyzes the outcome of ATG-refractory SAA patients activating a VUD search. Of 179 patients, 68 had at least one HLA-A, -B, and -DR matched donor identified and underwent HSCT while 50 also with a donor were not transplanted because of early death (8), late response to IST (34), transplant refusal (1), or other (7). Conversely, 61 had no matched donor, 13 of those ultimately received a mismatched HSCT. All but one received marrow stem cells. Among patients aged <17 years, those with at least one matched donor had a significant higher 4-year survival as compared to others (79%+/- 6% versus 53%+/- 10%, P=0.01). There was also a survival advantage independent of recipient age when the donor search was initiated in the recent 2000-2005 study-period (74%+/- 6% versus 47%+/- 10%, P<0.05). In multivariate analysis, the identification of a matched VUD tended to impact favourably on survival in patients with a recent donor search (P=0.07). This study provides evidence for the use of unrelated donor HSCT in children and adults with IST-refractory SAA. Am. J. Hematol. 88:868-873, 2013. (c) 2013 Wiley Periodicals, Inc.
KW - N/A
KW - N/A
UR - http://hdl.handle.net/10807/243975
U2 - 10.1002/ajh.23522
DO - 10.1002/ajh.23522
M3 - Article
SN - 1096-8652
VL - 88
SP - 868
EP - 873
JO - American Journal of Hematology
JF - American Journal of Hematology
ER -