Consider Allogeneic Bone Marrow Transplantation for Older, FitPatients with Aplastic Anemia

Georges, George E.

doi:10.1016/j.bbmt.2019.01.015

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…For patients receiving upfront MRD-HCT, long-term survival is more than 90% for young children [75] and more than 80% for adolescents [76]. For patients between 40-50 years without MRD and those >50 years of age with MRD, the frontline treatment should be individualized based on transplant risk factors, physical status, comorbidities, disease severity, genetic markers and probability of responding to IST [77]. Although treatment with triple therapy (ATG, CSA, and eltrombopag) has good outcome, the HCT option may be more affordable and readily available in many developing countries.…”

Section: Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Special issues related to the diagnosis and management of acquired aplastic anemia in countries with restricted resources, a report on behalf of the Eastern Mediterranean blood and marrow transplantation (EMBMT) group and severe aplastic anemia working party of the European Society for blood and marrow transplantation (SAAWP of EBMT)

Iftikhar¹,

Ahmad

Latour

et al. 2021

Bone Marrow Transplant

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Aplastic anemia is a relatively rare but potentially fatal disorder, with a reported higher incidence in developing countries in comparison to the West. There are significant variations in epidemiological as well as etiological factors of bone marrow failure syndromes in the developing countries in comparison to the developed world. Furthermore, the management of bone marrow failure syndromes in resource constraint settings has significant challenges including delayed diagnosis and referral, limited accessibility to healthcare facilities, treatment modalities as well as limitations related to patients who require allogeneic stem cell transplantation. Here we will provide a review of the available evidence related to specific issues of aplastic anemia in the developing countries and we summarize suggested recommendations from the Eastern Mediterranean blood and bone marrow transplantation (EMBMT) group and the severe aplastic anemia working party of the European Society of blood and marrow transplantation (SAAWP of EBMT) related to the diagnosis and therapeutic options in countries with restricted resources.

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Section: Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Special issues related to the diagnosis and management of acquired aplastic anemia in countries with restricted resources, a report on behalf of the Eastern Mediterranean blood and marrow transplantation (EMBMT) group and severe aplastic anemia working party of the European Society for blood and marrow transplantation (SAAWP of EBMT)

Iftikhar¹,

Ahmad

Latour

et al. 2021

Bone Marrow Transplant

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“…Despite the improvement of conditioning regimens, GVHD prophylaxis, and supportive care, there remains a higher mortality rate in older recipients diagnosed with SAA [3][4][5][6][7] . In the setting of SAA, the correlation between age and worse outcome could be related to the fact that older patients are more likely to have had IST before alloHSCT, a longer interval of time between diagnosis and transplant, or worse Karnofsky performance status(KPS) 37,38 . In our study, those patients who received prior IST and who had a KPS of 70-80% had a worse post-transplant outcome.…”

Section: Discussionmentioning

confidence: 99%

High Overall and GVHD-Free Survival in Patients with Aplastic Anemia Receiving in vivo T-cell Depletion Transplants and Long-Term Complications

Salas

Atenafu

Lam

et al. 2020

BCT

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We report a single-center experience of allogeneic hematopoietic stem cell transplant for patients with severe aplastic anemia over 13 years of age. Fifty-eight patients were included, and in vivo T-cell depletion was used in all cases. Fifty-one (88%) received alemtuzumab and 7 (12%) were given rabbit anti-thymocyte globulin. The median follow-up period was 6 years(range： 0-13.5) . Data was collected retrospectively and updated in April 2019. The median age was 31 years (range： 18-67) . Forty (69%) recipients received grafts from related donors and 18 (31%) received them from unrelated donors. Peripheral blood grafts were infused in 12(20.7%)patients. Five-year overall survival (OS) was 80.7%. Five-year graft-versus-host disease (GVHD) ／rejection-free survival was 56%. Eight (13.8%)patients experienced graft failure. The cumulative incidence of grade Ⅱ-Ⅳ acute GVHD at day 100 was 14% and that of chronic GVHD at 1 year was 7%. The selection of unrelated donors and the use of peripheral blood grafts were not significant risk factors for clinically relevant GVHD or for lower OS. Recipients older than 40 years showed significantly worse OS, as observed from the results of univariate analysis. T-cell depletion in severe aplastic anemia shows low rates of GVHD and high OS, but older patients remain a group with higher risk of mortality. Long-term complications were mainly autoimmune in character.Key words：severe aplastic anemia, allogeneic stem cell transplant, outcome, anti-thymocyte globulin, alemtuzumab

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Consider Allogeneic Bone Marrow Transplantation for Older, FitPatients with Aplastic Anemia

Cited by 2 publications

References 24 publications

High Overall and GVHD-Free Survival in Patients with Aplastic Anemia Receiving in vivo T-cell Depletion Transplants and Long-Term Complications

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