Allo-HSCT compared with immunosuppressive therapy for acquired aplastic anemia: a system review and meta-analysis

Zhu, Yongjian; Gao, Qingyan; Hu, Jing; Liu, Xu; Guan, Dongrui; Zhang, Fengkui

doi:10.1186/s12865-020-0340-x

Cited by 17 publications

(11 citation statements)

References 32 publications

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“…To the editor Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and immunosuppressive therapy (IST) are the two main treatment strategies for newly diagnosed severe aplastic anemia (SAA) [1]. In spite of comparable overall survival (OS) between matched related donor-HSCT (MRD-HSCT) and IST, failure-free survival (FFS) has been reported to often be better in the former than the latter [2,3], mainly because of a low rate of complete response (CR) and relatively high rate of relapse and clonal evolution after IST treatment [4]. In recent years, the addition of eltrombopag (EPAG), an oral synthetic small-molecule thrombopoietin receptor agonist, to standard IST has been shown to improve the speed and depth of a hematological response in patients with SAA, without additional toxic effects [5,6].…”

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confidence: 99%

Matched related transplantation versus immunosuppressive therapy plus eltrombopag for first-line treatment of severe aplastic anemia: a multicenter, prospective study

Liu

Lei

et al. 2022

J Hematol Oncol

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This study prospectively compared the efficacy and safety between matched related donor-hematopoietic stem cell transplantation (MRD-HSCT) (n = 108) and immunosuppressive therapy (IST) plus eltrombopag (EPAG) (IST + EPAG) (n = 104) to determine whether MRD-HSCT was still superior as a front-line treatment for patients with severe aplastic anemia (SAA). Compared with IST + EPAG group, patients in the MRD-HSCT achieved faster transfusion independence, absolute neutrophil count ≥ 1.0 × 109/L (P < 0.05), as well as high percentage of normal blood routine at 6-month (86.5% vs. 23.7%, P < 0.001). In the MRD-HSCT and IST + EPAG groups, 3-year overall survival (OS) was 84.2 ± 3.5% and 89.7 ± 3.1% (P = 0.164), whereas 3-year failure-free survival (FFS) was 81.4 ± 4.0% and 59.1 ± 4.9% (P = 0.002), respectively. Subgroup analysis indicated that the FFS of the MRD-HSCT was superior to that of the IST + EPAG among patients aged < 40 years old (81.0 ± 4.6% vs. 63.7 ± 6.5%, P = 0.033), and among patients with vSAA (86.1 ± 5.9% vs. 54.9 ± 7.9%, P = 0.003), while the 3-year OS of the IST + EPAG was higher than that of the MRD-HSCT among the patient aged ≥ 40 years old (100.0 ± 0.0% vs. 77.8 ± 9.8%, P = 0.036). Multivariate analysis showed that first-line MRD-HSCT treatment was associated favorably with normal blood results at 6-month and FFS (P < 0.05). These outcomes suggest that MRD-HSCT remains the preferred first-line option for SAA patients aged < 40 years old or with vSAA even in the era of EPAG.

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confidence: 99%

Matched related transplantation versus immunosuppressive therapy plus eltrombopag for first-line treatment of severe aplastic anemia: a multicenter, prospective study

Liu

Lei

et al. 2022

J Hematol Oncol

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“…It has to be emphasized that the choice of initial treatment for patients with newly diagnosed AA still requires a comprehensive evaluation of donor availability, patient age, expected quality of life, and the risk of disease relapse or clonal evolution after IST [94].…”

Section: Survival After Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

The impact of clonal hematopoiesis on outcomes in patients with aplastic anemia

Brzeźniakiewicz‐Janus

Rupa‐Matysek

Hoppe

et al. 2021

Acta Haematol Pol.

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“…30%-40% of patients showed no response to treatment with antithymocyte globulin (ATG), which will also consume platelets. Allo-HSCT is considered as the rst-line treatment for young and adult patients who may have an HLA-matched sibling donor (MSD) [6][7][8]. A study conducted by the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation (SAAWP-EBMT) showed that graft-versus-host diseasefree, relapse-free survival (GRFS) of allo-HSCT for AA was only 69% over 5 years [9].…”

Section: Introductionmentioning

confidence: 99%

Medication Regularity of Traditional Chinese Medicine in the Treatment of Aplastic Anemia Based on Data Mining

Dong

Zhang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. Aplastic anemia (AA) is an uncommon disease, characterized by pancytopenia and hypocellular bone marrow, but it is common in the blood system. The medication rules of traditional Chinese medicine (TCM) in the treatment of AA are not clear, for which it is worth exploring the medication rules by data mining methods. Methods. This study used SPSS Modeler 18.0 and SPSS statistics to analyze the cases of AA from Zhejiang Provincial Hospital of Chinese Medicine (ZJHCM) from March 1, 2019, to March 1, 2022. Data mining methods, including frequency analysis, cluster analysis, and association rule learning, were performed in order to explore the medication rules for AA. Results. (1) A total of 859 prescriptions, which met the inclusion criteria, consisted of 255 herbs. In descending order of the frequency of herbal medicine, we have Danggui, Huangqi, Shudihuang, Fuling, Gancao, Shanyao, Shanzhuyu, Baizhu, Dangshen, and Xianhecao. (2) Frequency analysis of herb properties: the Four Qi of 255 kinds of TCMs are mainly warm and neutral medicines. The Five Flavors are mainly sweet medicines, followed by bitter medicines. The main meridians are the liver, spleen, and kidney. (3) Clustering of medications: TCMs with the top 20 frequencies are classified into 9 groups by cluster analysis. (4) Association rule analysis of high-frequency herbs: using the Apriori algorithm, the results showed that there were 3 herb pairs with support of over 0.3 and 12 herb pairs with confidence above 0.85. Conclusion. The basic pathogenesis of AA (Sui Lao) is spleen and kidney essence deficiency, Qi deficiency, and blood stasis. The main herbs have warm and neutral properties, sweet tastes, and liver, spleen, and kidney meridian tropisms, whose purpose is to tonify the kidney and invigorate the spleen, tonify Qi, and promote blood circulation.

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Allo-HSCT compared with immunosuppressive therapy for acquired aplastic anemia: a system review and meta-analysis

Cited by 17 publications

References 32 publications

Matched related transplantation versus immunosuppressive therapy plus eltrombopag for first-line treatment of severe aplastic anemia: a multicenter, prospective study

Matched related transplantation versus immunosuppressive therapy plus eltrombopag for first-line treatment of severe aplastic anemia: a multicenter, prospective study

The impact of clonal hematopoiesis on outcomes in patients with aplastic anemia

Medication Regularity of Traditional Chinese Medicine in the Treatment of Aplastic Anemia Based on Data Mining

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