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Allogeneic stem cell transplantation for children with acquired severe aplastic anaemia: a retrospective study by the V iva‐ A sia B lood and M arrow T ransplantation G roup
Author(s) -
Chen Jing,
Lee Vincent,
Luo Cheng Juan,
Chiang Alan Kwok Shing,
Hongeng Suradej,
Tan Poh Lin,
Tan Ah Moy,
Sanpakit Kleebsabai,
Li Chun Fu,
Lee Anselm Chiwai,
Chua Hsin Chieh,
Okamoto Yasuhiro
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12405
Subject(s) - medicine , univariate analysis , gastroenterology , stem cell , multivariate analysis , hematopoietic stem cell transplantation , haematopoiesis , aplastic anemia , transplantation , bone marrow , immunology , biology , genetics
Summary We retrospectively analysed the outcomes of 127 children with acquired severe aplastic anaemia ( SAA ) who had received haematopoietic stem cell transplantation ( HSCT ) between 2000 and 2011 in one of the 10 Asia Pacific institutions. Fifty‐three were matched sibling donor ( MSD ) and 74 were alternative donor ( AD ), including 22 matched unrelated donor, 32 mismatched unrelated donor and 20 mismatched related donor. With a median follow up 45·5 months (13–139) and when compared to the MSD group, AD recipients had more grade II ‐ IV acute graft‐versus‐host disease (a GVHD ; 14·3% vs. 32·8%, P = 0·029), but similar grade III ‐ IV a GVHD (10·2% vs. 12·5%, P = 0·774), graft failure ( GF ) (15·1% vs. 15·5%, P = 0·658) and 5‐year overall survival (90·6% vs. 83·7%, P = 0·251). As a source of stem cell, peripheral blood stem cells ( PBSC ) resulted in less GF (18% vs. 9·1% P = 0·013), similar grade II‐IV a GVHD (28·1% vs. 17·4%, P = 0·258), chronic GVHD (25·8% vs. 29·3%, P = 0·822) and similar outcomes (89·7% vs. 82·4%, P =0 ·665) when compared to bone marrow ( BM ). In univariate analysis, GF ( P < 0·001) and grade II ‐ IV a GVHD ( P = 0·009) were predictors of poor survival. In multivariate analysis, only GF was associated with poor survival ( P = 0·012). The outcome of AD and PBSC HSCT were comparable to that of MSD and BM HSCT in the A sia P acific region.