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Recent improvement in outcome of unrelated donor transplantation for aplastic anemia

Viollier, R; Socie, G; Tichelli, A; Bacigalupo, A; Korthof, ET; Marsh, J; Cornish, J; Ljungman, P; Oneto, R and Békássy, Albert LU , et al. (2008) In Bone Marrow Transplantation 41(1). p.45-50
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... (More)
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.Bone Marrow Transplantation advance online publication, 5 November 2007; doi:10.1038/sj.bmt.1705894. (Less)
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Bone Marrow Transplantation
volume
41
issue
1
pages
45 - 50
publisher
Nature Publishing Group
external identifiers
  • pmid:17982502
  • wos:000252388700008
  • scopus:38349051039
ISSN
1476-5365
DOI
10.1038/sj.bmt.1705894
language
English
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yes
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99c5afbf-7c73-4eae-af21-a8d2d0878a39 (old id 1138447)
date added to LUP
2008-08-05 12:12:32
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2017-09-03 03:37:24
@article{99c5afbf-7c73-4eae-af21-a8d2d0878a39,
  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&lt;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&lt;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.Bone Marrow Transplantation advance online publication, 5 November 2007; doi:10.1038/sj.bmt.1705894.},
  author       = {Viollier, R and Socie, G and Tichelli, A and Bacigalupo, A and Korthof, ET and Marsh, J and Cornish, J and Ljungman, P and Oneto, R and Békássy, Albert and Fuehrer, M and Maury, S and Schrezenmeier, H and van Lint, MT and Wojcik, D and Locasciulli, A and Passweg, J R},
  issn         = {1476-5365},
  language     = {eng},
  number       = {1},
  pages        = {45--50},
  publisher    = {Nature Publishing Group},
  series       = {Bone Marrow Transplantation},
  title        = {Recent improvement in outcome of unrelated donor transplantation for aplastic anemia},
  url          = {http://dx.doi.org/10.1038/sj.bmt.1705894},
  volume       = {41},
  year         = {2008},
}