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

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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 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.

Detaljer

Författare
  • Krista Vaht
  • Magnus Göransson
  • Kristina Carlson
  • Cecilia Isaksson
  • Stig Lenhoff
  • Anna Sandstedt
  • Bertil Uggla
  • J. Winiarski
  • Per Ljungman
  • Per Ola Andersson
  • Mats Brune
Enheter & grupper
Externa organisationer
  • Sahlgrenska University Hospital
  • Queen Silvia Children’s Hospital
  • Uppsala University Hospital
  • Norrland University Hospital
  • Skåne University Hospital
  • Örebro University
  • Karolinska University Hospital
  • Karolinska Institute
  • Västra Götalandsregionen
  • Göteborgs universitet
  • Linköping University Hospital
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Hematologi

Nyckelord

Originalspråkengelska
TidskriftBiology of Blood and Marrow Transplantation
StatusE-pub ahead of print - 2019 jun 4
PublikationskategoriForskning
Peer review utfördJa