Premium
Second allogeneic stem cell transplant for aplastic anaemia: a retrospective study by the severe aplastic anaemia working party of the European society for blood and marrow transplantation
Author(s) -
Cesaro Simone,
Latour Regis Peffault,
Tridello Gloria,
Pillon Marta,
Carlson Kristina,
Fagioli Franca,
Jouet JeanPierre,
Koh Mickey B. C.,
Panizzolo Irene Sara,
KyrczKrzemien Slawomira,
Maertens Johan,
Rambaldi Alessandro,
Strahm Brigitte,
Blaise Didier,
Maschan Alexei,
Marsh Judith,
Dufour Carlo
Publication year - 2015
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.13650
Subject(s) - medicine , bone marrow , stem cell , transplantation , hematopoietic stem cell transplantation , aplastic anemia , gastroenterology , haematopoiesis , hematology , surgery , immunology , biology , genetics
Summary We analysed the outcome of a second allogeneic haematopoietic stem cell transplant (allo HSCT ) 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 allo HSCT 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 allo HSCT is feasible rescue option for GF in SAA , with a successful outcome in 60% of cases.