

Other version: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692140/pdf/nihms111773.pdf
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Risk factors affecting outcome of second HLA-matched sibling donor transplantations for graft failure in severe acquired aplastic anemia |
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Published in | Biology of Blood and Marrow Transplantation. 2009, vol. 15, no. 5, p. 626-631 | |
Abstract | We examined transplantation outcomes after a second HLA-matched sibling transplantation for primary (16%) or secondary (84%) graft failure in 166 patients with severe acquired aplastic anemia (AA). Two-thirds of these patients has a performance score < 90. In most cases (88%), the same donor was used for both transplants, for both transplantations, and 84% of the second transplantations used bone marrow grafts. We identified 2 prognostic factors: intertransplantation interval (surrogate for primary graft failure and early secondary graft failure) and performance status. Shorter intertransplantation interval ( ≤ 3 months) and poor performance score (< 90) at second transplantation were associated with high mortality. In patients with a performance score of 90% to 100%, the 8-year probability of overall survival (OS) after second transplantation ≤ 3 and > 3 months from first transplantation was 56% and 76%, respectively. The corresponding probabilities in patients with lower performance scores were 33% and 61%. The predominant cause of failure after second transplantation was nonengraftment (in 72 of 166 patients), most commonly in patients with primary or early secondary graft failure (51 of 72; 71%). Our data indicate that novel approaches, including conditioning regimens with greater immunosuppression, should be explored for these patients. | |
Keywords | Adolescent — Adult — Anemia, Aplastic/*surgery — Bone Marrow Transplantation/*methods — Child — Female — Graft Rejection/*diagnosis — Hematopoiesis — Histocompatibility Testing — Humans — Male — Prognosis — Reoperation — Risk Factors — Siblings — Tissue Donors — Treatment Outcome — Young Adult | |
Identifiers | PMID: 19361755 | |
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![]() ![]() Other version: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2692140/pdf/nihms111773.pdf |
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Citation (ISO format) | HORAN, John T. et al. Risk factors affecting outcome of second HLA-matched sibling donor transplantations for graft failure in severe acquired aplastic anemia. In: Biology of Blood and Marrow Transplantation, 2009, vol. 15, n° 5, p. 626-631. doi: 10.1016/j.bbmt.2009.01.023 https://archive-ouverte.unige.ch/unige:19861 |