TY - JOUR
T1 - Second allogeneic stem cell transplant for aplastic anaemia
T2 - A retrospective study by the severe aplastic anaemia working party of the European society for blood and marrow transplantation
AU - Cesaro, Simone
AU - de Latour, Regis Peffault
AU - Tridello, Gloria
AU - Pillon, Marta
AU - Carlson, Kristina
AU - Fagioli, Franca
AU - Jouet, Jean Pierre
AU - Koh, Mickey B C
AU - Panizzolo, Irene Sara
AU - Kyrcz-Krzemien, Slawomira
AU - Maertens, Johan
AU - Rambaldi, Alessandro
AU - Strahm, Brigitte
AU - Blaise, Didier
AU - Maschan, Alexei
AU - Marsh, Judith
AU - Dufour, Carlo
PY - 2015/11/1
Y1 - 2015/11/1
N2 - 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.
AB - 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.
KW - Graft failure
KW - Haematopoietic stem cell transplantation
KW - Rescue treatment
KW - Second allogeneic transplant
KW - Severe aplastic anaemia
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U2 - 10.1111/bjh.13650
DO - 10.1111/bjh.13650
M3 - Article
C2 - 26304743
AN - SCOPUS:84945439133
VL - 171
SP - 606
EP - 614
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 4
ER -