Second allogeneic stem cell transplant for aplastic anaemia: A retrospective study by the severe aplastic anaemia working party of the European society for blood and marrow transplantation

Simone Cesaro, Regis Peffault de Latour, Gloria Tridello, Marta Pillon, Kristina Carlson, Franca Fagioli, Jean Pierre Jouet, Mickey B C Koh, Irene Sara Panizzolo, Slawomira Kyrcz-Krzemien, Johan Maertens, Alessandro Rambaldi, Brigitte Strahm, Didier Blaise, Alexei Maschan, Judith Marsh, Carlo Dufour

Research output: Contribution to journalArticlepeer-review

Abstract

We analysed the outcome of a second allogeneic haematopoietic stem cell transplant (alloHSCT) in 162 patients reported to the European Society for Blood and Marrow Transplantation between 1998 and 2009. Donor origin was a sibling in 110 and an unrelated donor in 52 transplants, respectively. The stem cell source was bone marrow in 31% and peripheral blood in 69% of transplants. The same donor as for the first alloHSCT was used in 81% of transplants whereas a change in the choice of stem cell source was reported in 56% of patients, mainly from bone marrow to peripheral blood. Neutrophil and platelet engraftment occurred in 85% and 72% of patients, after a median time of 15 and 17 days, respectively. Grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD occurred in 21% and 37% of patients, respectively. Graft failure (GF) occurred in 42 patients (26%). After a median follow-up of 3·5 years, the 5-year overall survival (OS) was 60·7%. In multivariate analysis, the only factor significantly associated with a better outcome was a Karnofsky/Lansky score ≥80 (higher OS). We conclude that a second alloHSCT is feasible rescue option for GF in SAA, with a successful outcome in 60% of cases.

Original languageEnglish
Pages (from-to)606-614
Number of pages9
JournalBritish Journal of Haematology
Volume171
Issue number4
DOIs
Publication statusPublished - Nov 1 2015

Keywords

  • Graft failure
  • Haematopoietic stem cell transplantation
  • Rescue treatment
  • Second allogeneic transplant
  • Severe aplastic anaemia

ASJC Scopus subject areas

  • Hematology

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