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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
Section of Hematology and Coagulation, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Hematology, Uppsala University Hospital, Uppsala, Sweden.
Department of Hematology, Cancer Centre, University Hospital, Umeå, Sweden.
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2019 (English)In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 25, no 10, p. 1970-1974Article in journal (Refereed) Published
Abstract [en]

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% (A=.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. (C) 2019 American Society for Transplantation and Cellular Therapy.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 25, no 10, p. 1970-1974
Keywords [en]
Aplastic anemia, Allogenic stem cell transplantation, Graft-versus-host disease-free, Relapse/rejection-free survival, Real-world data
National Category
Hematology Immunology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-77818DOI: 10.1016/j.bbmt.2019.05.032ISI: 000492801700008PubMedID: 31173901Scopus ID: 2-s2.0-85068208816OAI: oai:DiVA.org:oru-77818DiVA, id: diva2:1369618
Note

Funding Agencies:

Gothenburg Medical Society

Borås Cancer Foundation  

Swedish government  

ALF  ALFGBG-719481

Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2019-11-12Bibliographically approved

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Uggla, Bertil

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