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Title

Improved outcome of patients older than 30 years receiving HLA-identical sibling hematopoietic stem cell transplantation for severe acquired aplastic anemia using fludarabine-based conditioning: a comparison with conventional conditioning regimen

Authors
Maury, Sébastien
Bacigalupo, Andrea
Anderlini, Paolo
Aljurf, Mahmoud
Marsh, Judith
Socie, Gerard
Oneto, Rosi
Published in Haematologica. 2009, vol. 94, no. 9, p. 1312-1315
Abstract Older age is a limitation for HLA-identical sibling hematopoietic stem cell transplantation (HSCT) as first-line therapy for severe acquired idiopathic aplastic anemia (SAA). Fludarabine (Flu)-based conditioning might improve outcome in older patients. We analyzed retrospectively 30 patients older than 30 years receiving such reduced-intensity conditioning HSCT according to recommendations of the European Group for Blood and Marrow Transplantation (EBMT) and compared their outcome to a control group receiving the standard regimen (cyclophosphamide+/-antithymocyte globulin) over the same study period (1998-2007). Patients conditioned with Flu had a higher probability of overall survival than the control group (p=0.04) when adjusting for recipient's age. This might be related to a trend towards a reduced incidence of graft failure in patients receiving Flu (0% vs. 11%, p=0.09), while no difference was observed regarding graft-versus-host disease incidence. Flu-based conditioning regimen may reduce the negative impact of age in older patients with SAA receiving an HLA-identical sibling HSCT.
Keywords AdultAgedAnemia, Aplastic/mortality/*therapyAntilymphocyte Serum/administration & dosageCyclophosphamide/administration & dosageDisease-Free SurvivalFemaleFollow-Up StudiesHLA Antigens*Hematopoietic Stem Cell TransplantationHumansImmunosuppressive Agents/administration & dosage*Living DonorsMaleMiddle AgedMyeloablative Agonists/*administration & dosageRetrospective Studies*SiblingsSurvival RateTransplantation Conditioning/*methodsTransplantation, HomologousVidarabine/administration & dosage/*analogs & derivatives
Identifiers
PMID: 19734425
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MAURY, Sébastien et al. Improved outcome of patients older than 30 years receiving HLA-identical sibling hematopoietic stem cell transplantation for severe acquired aplastic anemia using fludarabine-based conditioning: a comparison with conventional conditioning regimen. In: Haematologica, 2009, vol. 94, n° 9, p. 1312-1315. https://archive-ouverte.unige.ch/unige:19945

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Deposited on : 2012-04-23

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