Unrelated alternative donor transplantation for severe acquired aplastic anemia: A study from the french society of bone marrow transplantation and cell therapies and the EBMT severe aplastic anemia working party

Raynier Devillier, Jean Hugues Dalle, Austin Kulasekararaj, Maud D'aveni, Laurence Clément, Alicja Chybicka, Stephane Vigouroux, Patrice Chevallier, Mickey B C Koh, Y. Bertrand, M. Michallet, Marco Zecca, Ibrahim Yakoub-Agha, J. Cahn, Per Ljungman, M. Bernard, Pascale Loiseau, V. Dubois, Sébastien Maury, Gerard SocièCarlo Dufour, Regis Peffault de Latour

Research output: Contribution to journalArticlepeer-review

Abstract

Unrelated allogeneic transplantation for severe aplastic anemia is a treatment option after immunosuppressive treatment failure in the absence of a matched sibling donor. Age, delay between disease diagnosis and transplantation, and HLA matching are the key factors in transplantation decisions, but their combined impact on patient outcomes remains unclear. Using the French Society of Bone Marrow Transplantation and Cell Therapies registry, we analyzed all consecutive patients (n=139) who underwent a first allogeneic transplantation for idiopathic severe aplastic anemia from an unrelated donor between 2000 and 2012. In an adjusted multivariate model, age over 30 years (Hazard Ratio=2.39; P=0.011), time from diagnosis to transplantation over 12 months (Hazard Ratio=2.18; P=0.027) and the use of a 9/10 mismatched unrelated donor (Hazard Ratio=2.14; P=0.036) were independent risk factors that significantly worsened overall survival. Accordingly, we built a predictive score using these three parameters, considering patients at low (zero or one risk factors, n=94) or high (two or three risk factors, n=45) risk. High-risk patients had significantly shorter survival (Hazard Ratio=3.04; P

Original languageEnglish
Pages (from-to)884-890
Number of pages7
JournalHaematologica
Volume101
Issue number7
DOIs
Publication statusPublished - 2016

ASJC Scopus subject areas

  • Hematology

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