Comparison between Matched Related and Alternative Donors of Allogeneic Hematopoietic Stem Cells Transplanted into Adult Patients with Acquired Aplastic Anemia: Multivariate and Propensity Score-Matched Analysis

Title
Comparison between Matched Related and Alternative Donors of Allogeneic Hematopoietic Stem Cells Transplanted into Adult Patients with Acquired Aplastic Anemia: Multivariate and Propensity Score-Matched Analysis
Author(s)
현명수김학[김학]김병수[김병수]김동환[김동환]김성현[김성현]배성화[배성화]최정혜[최정혜]손상균[손상균]신호진[신호진]원종호[원종호]윤성수[윤성수]조덕연[조덕연]주영돈[주영돈]박재후[박재후]이규형[이규형]
Keywords
BONE-MARROW-TRANSPLANTATION; TOTAL-BODY IRRADIATION; ANTI-THYMOCYTE GLOBULIN; COLONY-STIMULATING FACTOR; IMMUNOSUPPRESSIVE THERAPY; UNRELATED DONORS; ANTILYMPHOCYTE GLOBULIN; ANTITHYMOCYTE GLOBULIN; CYCLOPHOSPHAMIDE; CHILDREN
Issue Date
201109
Publisher
ELSEVIER SCIENCE INC
Citation
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, v.17, no.9, pp.1289 - 1298
Abstract
We retrospectively compared the outcomes of 225 patients with adult acquired aplastic anemia (AA) who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT) from matched related donors (MRDs), and those treated by alloHSCT from alternative donors (ADs). Univariate and multivariate analyses of factors associated with survival were performed. Multivariate analysis showed that age at alloHSCT of <= 31 years, MRD, successful engraftment, absence of acute graft-versus-host disease (aGVHD), and platelet engraftment at <= 21 days, were independent predictors of longer survival. In addition, time to aGVHD and cumulative nonrelapse mortality (NRM) were better in MRD than in AD recipients. Using propensity score matching (PSM), we performed a case-control study comparing 25 patients in each group who underwent alloHSCT from MRDs and ADs. Pretransplantation clinical factors were well balanced in either group. Median survival time was similar, and no statistically significant difference in transplantation outcomes was apparent when MRD and AD recipients were compared. In conclusion, our results suggest that alloHSCT from an AD should be considered earlier in adult patients with AA who do not have an MRD. Biol Blood Marrow Transplant 17: 1289-1298 (2011) (C) 2011 American Society for Blood and Marrow Transplantation
URI
http://hdl.handle.net/YU.REPOSITORY/24645http://dx.doi.org/10.1016/j.bbmt.2010.12.715
ISSN
1083-8791
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의과대학 > 내과학교실 > Articles
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