Journal
ACTA HAEMATOLOGICA
Volume 143, Issue 3, Pages 232-243Publisher
KARGER
DOI: 10.1159/000501496
Keywords
Stem cell source; Stem cell dose; Allogeneic hematopoietic stem cell transplantation; Idiopathic aplastic anemia; Korean aplastic anemia trials
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Funding
- Priority Research Center Program through the National Research Foundation of Korea - Ministry of Education, Science, and Technology [2009-0094050]
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Objective:We aimed to evaluate the effect of stem cell source and dose on the survival of various donor subgroups, such as matched sibling donor (MSDs) and alternative donors (ADs), upon bone marrow (BM) or peripheral blood stem cell (PBSC) infusion in aplastic anemia (AA).Methods:We retrospectively investigated the effects of stem cell source and dose on allogeneic hematopoietic stem cell transplantation (alloHSCT) in AA.Results:A total of 267 patients were included in this analysis. The BM-treated group showed an association with low incidence of any-grade acute graft versus host disease (GvHD) (p< 0.001). A higher stem cell dose was related with a low incidence of extensive chronic GvHD in MSDs (p= 0.025). Multivariate analysis for overall survival (OS) revealed that only age at alloHSCT <31 years (p= 0.010) and prior platelet transfusion <86 U (p= 0.046) in MSDs and higher stem cell dose (hazard ratio = 2.596,p= 0.045) in ADs were favorable prognostic factors.Conclusion:PBSCs could be preferred in AD because high stem cell dose may be easily achieved to improve the OS at the expense of acute GvHD. However, BM stem cells are preferred in MSDs.
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