Matched related donor hematopoietic stem cell transplantation results in a long-term follow-up of a pediatric acquired severe aplastic anemia subset: A stem cell source perspective

被引:10
作者
Hamidieh, Amir Ali [1 ]
Mozafari, Mohammad [1 ]
Noshad, Sina [1 ]
Alimoghaddam, Kamran [1 ]
Behfar, Maryam [1 ]
Ghavamzadeh, Ardeshir [1 ]
机构
[1] Univ Tehran Med Sci, Hematol Oncol & Stem Cell Transplantat Res Ctr, Tehran 14114, Iran
关键词
hematopoietic stem cell transplantation; aplastic anemia; pediatric; related donor; BONE-MARROW-TRANSPLANTATION; VERSUS-HOST-DISEASE; PERIPHERAL-BLOOD; SIBLING DONOR; MIXED CHIMERISM; CYCLOSPORINE-A; CHILDREN; OUTCOMES; SCT; FLUDARABINE;
D O I
10.1111/petr.12458
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
HSCT has substantially improved pediatric acquired SAA patients' outcomes. Retrospectively, we attempted to assess the outcome of MRD HSCT in 65 pediatric patients referred to a single center from 1992 to 2012. We were particularly interested to find out whether source of SC (PB, n=40 and BM, n=25) significantly impacts EFS and GVHD incidence. With a median follow-up of 45months, total EFS was 87.7%; EFS for PB and BM groups was 87.5% and 88%, respectively. Acute GVHD (grades 3-4) occurred in 13 patients (PB, n=10 [25%] and BM, n=3 [12%]), acute GVHD (grades 2-4) occurred in 24 (PB, n=16 [40%] and BM, n=8 [32%]). Extensive chronic GVHD occurred in five patients (PB, n=3 [7.5%] and BM, n=2 [8%]). Cox regression revealed that elapsed time of <10months between diagnosis and HSCT is associated with improved survival (hazard ratio, 95% CI=1.204, 1.010-1.434, p=0.038). SC source did not significantly affect EFS, incidence of acute GVHD (grades 3-4), or extensive chronic GVHD (p=0.938, 0.121, and 0.487, respectively). Based on our findings, pediatric acquired SAA patients are benefitted most if MRD-HSCT is carried out early in disease process and SC source does not affect outcome of MRD-HSCT in these patients.
引用
收藏
页码:399 / 407
页数:9
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