Premium
Outcome in patients with Wiskott–Aldrich syndrome following stem cell transplantation: an analysis of 57 patients in Japan
Author(s) -
Kobayashi Ryoji,
Ariga Tadashi,
oyama Shigeaki,
Kanegane Hirokazu,
Tsuchiya Shigeru,
Morio Tomohiro,
Yabe Hiromasa,
Nagatoshi Yoshihisa,
Kawa Keisei,
Tabuchi Ken,
Tsuchida Masahiro,
Miyawaki Toshio,
Kato Shunichi
Publication year - 2006
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/j.1365-2141.2006.06297.x
Subject(s) - busulfan , medicine , transplantation , cyclophosphamide , univariate analysis , surgery , cord blood , survival rate , gastroenterology , hematopoietic stem cell transplantation , multivariate analysis , chemotherapy
Summary A total of 57 patients with Wiskott–Aldrich syndrome (WAS) were studied after undergoing stem cell transplantation (SCT) in Japan between January 1985 and December 2004. Eleven patients received transplants from human leucocyte antigen (HLA)‐matched related donors, 10 from HLA‐mismatched related donors, 21 from unrelated bone marrow donors, and 15 from unrelated cord blood donors. Nine of the 57 patients rejected the initial graft. The overall 5‐year survival rate was 73·7% and the 5‐year failure‐free survival rate was 65·7% (failure was defined as rejection or death). The overall 5‐year survival rates for patients receiving bone marrow and cord blood from unrelated donors were both 80·0%. Based on univariate analysis, the factors associated with poor survival were: transplantation from an HLA‐mismatched related donor, patient age of more than 5 years at the time of transplantation, and a conditioning regimen other than busulfan and cyclophosphamide (BU‐CY) or busulfan, cyclophosphamide and antithymocyte globulin (BU‐CY‐ATG). In a multivariate analysis, a conditioning regimen other than BU‐CY and BU‐CY‐ATG was the only independent factor associated with transplantation failure. Given the improved outcome for WAS patients following transplantation from an unrelated donor, we conclude that patients with WAS should receive SCT as soon as possible after diagnosis.