Allogeneic hematopoietic cell transplantation without total body irradiation from unrelated donor in adult patients with idiopathic aplastic anemia: Fludarabine versus cyclophosphamide-ATG

Title
Allogeneic hematopoietic cell transplantation without total body irradiation from unrelated donor in adult patients with idiopathic aplastic anemia: Fludarabine versus cyclophosphamide-ATG
Author(s)
김민경김혁[김혁]이규형[이규형]김인호[김인호]손상균[손상균]정철원[정철원]주영돈[주영돈]김성현[김성현]김병수[김병수]최정혜[최정혜]곽재용[곽재용]배성화[배성화]신호진[신호진]원종호[원종호]이원식[이원식]오석중[오석중]김효정[김효정]박재후[박재후]
Keywords
BONE-MARROW-TRANSPLANTATION; MATCHED SIBLING DONORS; VERSUS-HOST-DISEASE; SAA WORKING PARTY; PERIPHERAL-BLOOD; ANTITHYMOCYTE GLOBULIN; VENOOCCLUSIVE DISEASE; CONDITIONING REGIMEN; OUTCOMES; REJECTION
Issue Date
201407
Publisher
PERGAMON-ELSEVIER SCIENCE LTD
Citation
LEUKEMIA RESEARCH, v.38, no.7, pp.730 - 736
Abstract
Total body irradiation (TBI) has traditionally been used in the conditioning regimen for allogenetic hematopoietic stem cell transplantation (alloHCT) from an unrelated donor (u-HCT). However, patients are increasingly receiving a fludarabine-based conditioning regimen without TBI, as it seemed less toxic than TBI. We need to know the clinical results of non-TBI u-HCT treatments. We retrospectively investigated the clinical outcomes of allogenetic hematopoietic cell transplantation (alloHCT) from an unrelated donor without TBI (non-TBI u-HCT) and compared the clinical outcomes of fludarabine-based (FLU group) and cyclophosphamide-ATG (Cy-ATG group) conditioning regimens. Sixty-one patients received the non-TBI conditioning regimen for u-HCT (32 in the FLU group and 29 in the Cy-ATG group). The cumulative incidence of neutrophil engraftment at 30 days, platelet > 20 K/mu L at 30 days, acute graft-versus host disease (aGvHD) at 100 days, and chronic GvHD (cGvHD) at 2 years were 87.01%, 65.57%, 35.20%, and 26.64%, respectively. However, transplantation outcomes and overall survival rates did not differ between the FLU and Cy-ATG groups. Only infused CD34+ cells >3 x 10(6) kg(-1) was identified as a favorable factor for survival in the multivariate analysis. In conclusion, non-TBI u-HCT was feasible and there was no difference between the FLU and Cy-ATG groups in terms of transplantation outcomes. (C) 2014 Published by Elsevier Ltd.
URI
http://hdl.handle.net/YU.REPOSITORY/31404http://dx.doi.org/10.1016/j.leukres.2014.01.002
ISSN
0145-2126
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의과대학 > 내과학교실 > Articles
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