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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
최정혜
Keywords
Unrelated dono; rTotal body irradiation; Aplastic anemia; Allogeneic hematopoietic stem cell transplantation; Fludarabine
Issue Date
2014-02
Publisher
Elsevier B.V
Citation
Leukemia Research July 2014, 38, 7, 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>20K/μL 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 >3×106kg?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.
URI
https://www.sciencedirect.com/science/article/pii/S0145212614000058http://hdl.handle.net/20.500.11754/49390
ISSN
0145-2126
DOI
10.1016/j.leukres.2014.01.002
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > ETC
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