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High Graft-versus-Host Disease-Free, Relapse/Rejection-Free Survival and Similar Outcome of Related and Unrelated Allogeneic Stem Cell Transplantation for Aplastic Anemia : A Nationwide Swedish Cohort Study

Vaht, Krista ; Göransson, Magnus ; Carlson, Kristina ; Isaksson, Cecilia ; Lenhoff, Stig LU ; Sandstedt, Anna ; Uggla, Bertil ; Winiarski, J. ; Ljungman, Per and Andersson, Per Ola , et al. (2019) In Biology of Blood and Marrow Transplantation 25(10). p.1970-1974
Abstract

Allogeneic stem cell transplantation (SCT) as primary treatment for aplastic anemia (AA) is being increasingly used. Yet, age, stem cell source, and donor type are important outcome factors. We have recently performed a nationwide cohort study of all patients with AA in Sweden diagnosed from 2000 to 2011 and now present outcome data on SCT patients. In total, 68 patients underwent SCT, and 63% of them had failed immunosuppressive therapy. We found that, with a median follow-up of 109 months (range, 35 to 192 months), 5-year overall survival (OS) for all patients was 86.8%, whereas graft-versus-host disease-free, relapse/rejection-free survival (GRFS) at 5 years was 69.1%. There was no survival impact regarding the donor type or stem... (More)

Allogeneic stem cell transplantation (SCT) as primary treatment for aplastic anemia (AA) is being increasingly used. Yet, age, stem cell source, and donor type are important outcome factors. We have recently performed a nationwide cohort study of all patients with AA in Sweden diagnosed from 2000 to 2011 and now present outcome data on SCT patients. In total, 68 patients underwent SCT, and 63% of them had failed immunosuppressive therapy. We found that, with a median follow-up of 109 months (range, 35 to 192 months), 5-year overall survival (OS) for all patients was 86.8%, whereas graft-versus-host disease-free, relapse/rejection-free survival (GRFS) at 5 years was 69.1%. There was no survival impact regarding the donor type or stem cell source. Patients aged ≥40 years had a higher transplant-related mortality (29.4% versus 7.8%; P = .023), which translated into a lower 5-year OS: 70.6% versus 92.2% (P = .022) and a trend of lower GRFS (52.9% versus 74.5%; P = .069). In conclusion, we found in this real-world setting that both OS and GRFS were high, but SCT for patients with AA aged ≥40 years is problematic, and clinical trials addressing this issue are warranted.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Allogenic stem cell transplantation, Aplastic anemia, Graft-versus-host disease-free, Real-world data, Relapse/rejection-free survival
in
Biology of Blood and Marrow Transplantation
volume
25
issue
10
pages
1970 - 1974
publisher
Elsevier
external identifiers
  • pmid:31173901
  • scopus:85068208816
ISSN
1083-8791
DOI
10.1016/j.bbmt.2019.05.032
language
English
LU publication?
yes
id
423ee224-4c8d-4346-914f-6a82b53c1771
date added to LUP
2019-07-10 14:50:20
date last changed
2024-04-16 16:15:07
@article{423ee224-4c8d-4346-914f-6a82b53c1771,
  abstract     = {{<p>Allogeneic stem cell transplantation (SCT) as primary treatment for aplastic anemia (AA) is being increasingly used. Yet, age, stem cell source, and donor type are important outcome factors. We have recently performed a nationwide cohort study of all patients with AA in Sweden diagnosed from 2000 to 2011 and now present outcome data on SCT patients. In total, 68 patients underwent SCT, and 63% of them had failed immunosuppressive therapy. We found that, with a median follow-up of 109 months (range, 35 to 192 months), 5-year overall survival (OS) for all patients was 86.8%, whereas graft-versus-host disease-free, relapse/rejection-free survival (GRFS) at 5 years was 69.1%. There was no survival impact regarding the donor type or stem cell source. Patients aged ≥40 years had a higher transplant-related mortality (29.4% versus 7.8%; P = .023), which translated into a lower 5-year OS: 70.6% versus 92.2% (P = .022) and a trend of lower GRFS (52.9% versus 74.5%; P = .069). In conclusion, we found in this real-world setting that both OS and GRFS were high, but SCT for patients with AA aged ≥40 years is problematic, and clinical trials addressing this issue are warranted.</p>}},
  author       = {{Vaht, Krista and Göransson, Magnus and Carlson, Kristina and Isaksson, Cecilia and Lenhoff, Stig and Sandstedt, Anna and Uggla, Bertil and Winiarski, J. and Ljungman, Per and Andersson, Per Ola and Brune, Mats}},
  issn         = {{1083-8791}},
  keywords     = {{Allogenic stem cell transplantation; Aplastic anemia; Graft-versus-host disease-free; Real-world data; Relapse/rejection-free survival}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{10}},
  pages        = {{1970--1974}},
  publisher    = {{Elsevier}},
  series       = {{Biology of Blood and Marrow Transplantation}},
  title        = {{High Graft-versus-Host Disease-Free, Relapse/Rejection-Free Survival and Similar Outcome of Related and Unrelated Allogeneic Stem Cell Transplantation for Aplastic Anemia : A Nationwide Swedish Cohort Study}},
  url          = {{http://dx.doi.org/10.1016/j.bbmt.2019.05.032}},
  doi          = {{10.1016/j.bbmt.2019.05.032}},
  volume       = {{25}},
  year         = {{2019}},
}