Outcomes of haploidentical bone marrow transplantation in patients with severe aplastic anemia-II that progressed from non-severe acquired aplastic anemia
Autor: | Yan Yang, Hengxiang Wang, Jing Shao, Jiajun Xie, Cheng-Tao Zhang, Xiaoli Zheng, Beibei Gao, Hongchen Liu, Jinsong Yan |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Transplantation Conditioning Graft vs Host Disease Salvage therapy Human leukocyte antigen Disease 03 medical and health sciences 0302 clinical medicine HLA Antigens immune system diseases hemic and lymphatic diseases Internal medicine medicine Humans In patient Aplastic anemia Survival rate Bone Marrow Transplantation business.industry Hematopoietic Stem Cell Transplantation Anemia Aplastic General Medicine medicine.disease Severe Aplastic Anemia surgical procedures operative 030220 oncology & carcinogenesis Rituximab business 030215 immunology medicine.drug |
Zdroj: | Frontiers of Medicine. 15:718-727 |
ISSN: | 2095-0225 2095-0217 |
DOI: | 10.1007/s11684-020-0807-4 |
Popis: | Severe aplastic anemia II (SAA-II) progresses from non-severe aplastic anemia (NSAA). The unavailability of efficacious treatment has prompted the need for haploidentical bone marrow transplantation (haplo-BMT) in patients lacking a human leukocyte antigen (HLA)-matched donor. This study aimed to investigate the efficacy of haplo-BMT for patients with SAA-II. Twenty-two patients were included and followed up, and FLU/BU/CY/ATG was used as conditioning regimen. Among these patients, 21 were successfully engrafted, 19 of whom survived after haplo-BMT. Four patients experienced grade II-IV aGvHD, including two with grade III-IV aGvHD. Six patients experienced chronic GvHD, among whom four were mild and two were moderate. Twelve patients experienced infections during BMT. One was diagnosed with post-transplant lymphoproliferative disorder and one with probable EBV disease, and both recovered after rituximab infusion. Haplo-BMT achieved 3-year overall survival and disease-free survival rate of 86.4% ± 0.73% after a median follow-up of 42 months, indicating its effectiveness as a salvage therapy. These promising outcomes may support haplo-BMT as an alternative treatment strategy for patients with SAA-II lacking HLA-matched donors. |
Databáze: | OpenAIRE |
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