4.6 Article

Outcomes after allogeneic haematopoietic stem cell transplantation in young adults in Germany

期刊

BRITISH JOURNAL OF HAEMATOLOGY
卷 201, 期 2, 页码 308-318

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WILEY
DOI: 10.1111/bjh.18610

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adolescents and young adults; allogeneic haematopoietic stem cell transplantation; AYA; outcome; survival

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This retrospective analysis examined the outcomes of young adults who underwent allogeneic haematopoietic stem cell transplantation (HSCT) in Germany. The study found that the outcomes of young adults after HSCT improved over time and were influenced by factors such as underlying disease, age at disease onset, stem cell source, and donor type. However, the survival rate of HSCT recipients after 10 years was significantly lower compared to the general population of young adults.
Young adults (YA) represent a minority among recipients of allogeneic haematopoietic stem cell transplantation (HSCT). In order to describe the outcome of YA following HSCT in Germany, 9299 patients who were registered with the German Registry for Stem Cell Transplantation were included in this retrospective analysis of the years 1998-2019. The impact of the variables, such as patient age and sex, sex differences, stem cell source, donor type, conditioning, year of HSCT, the diagnosis, and the achieved remission status were tested in univariable and multivariable analysis for overall, event-free and relapse-free survival as well as for the cumulative incidences of non-relapse and therapy-related mortality. Altogether, the outcome of YA after HSCT improved over time and was determined by the underlying disease, the age at disease onset, stem cell source, and donor type. Patients were most likely to die from relapse, and survival of HSCT recipients after 10 years was reduced by more than half in comparison to the general population of YA. Deeper understanding of modifiable risk factors may be gained by studies comparing the outcome of YA post-HSCT with that of children, adolescents and elderly patients. A deliberate and strong patient selection may further improve mortality rates.

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