Hematopoietic Stem Cell Transplantation for Severe Aplastic Anemia.
- Author:
Inho KIM
1
;
Dae Ho LEE
;
Soo Mee BANG
;
Jae Ho BYUN
;
Heung Moon CHANG
;
Moon Hee LEE
;
Young Jin YOO
;
Jin Seok AHN
;
Jong Tae LEE
;
Seok Ah IM
;
Chul Won JUNG
;
Sung Hyun YANG
;
Hong Bock LEE
;
Cheolwon SUH
;
Myung Don OH
;
Kang Won CHOE
;
Kyou Sup HAN
;
Myoung Hee PARK
;
Il Han KIM
;
Sung Whan HA
;
Charn Il PARK
;
Kyung Hae JUNG
;
Seonyang PARK
;
Byoung Kook KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Severe aplastic anemia;
Hematopoietic stem cell transplantation
- MeSH:
Accidents, Traffic;
Anemia, Aplastic*;
Cause of Death;
Cyclosporine;
Fathers;
Female;
Follow-Up Studies;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation*;
Hematopoietic Stem Cells*;
Humans;
Male;
Medical Records;
Methotrexate;
Neutrophils;
Platelet Count;
Pneumonia;
Retrospective Studies;
Seoul;
Siblings;
Tissue Donors;
Transplantation;
Transplants;
Twins, Monozygotic;
Unrelated Donors
- From:Korean Journal of Hematology
2000;35(3-4):195-205
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The outcome of hematopoietic stem cell transplantation (HSCT) for patients with severe aplastic anemia (SAA) in Seoul National University Hospital was analyzed retrospectively. METHODS: Between January, 1990 and March, 1999, 25 patients with SAA underwent HSCT. Their medical records were reviewed. Statistical analyses were done about survival and complication after HSCT. RESULTS: The median age of patients was 22 (range, 14~43) and male to female ratio was 18 : 7. Twenty two were HLA matched non- identical siblings. Three were one identical twin, one one-locus mismatched father and one HLA matched unrelated donor, respectively. Conditioning regimens were CY/TLI (cyclophosphamide, total lymphoid irradiation) for 18 patients, CY/ATG (CY, antithymocyte globulin) for 3, CY/ buffy (CY, unirradiated buffy- coat) for 2, CY/ ATG/TLI for 1, BU/CY (busulfan, CY) for 1. For prophylaxis of graft-versus-host disease (GVHD), cyclosporine and methotrexate were used in all patients except for identical twin. The median nucleated cell dose given to patients was 4.5x108/kg (range, 2.0~5.9). All evaluable patients achieved absolute neutrophil count of 500/microliter after median 17 days of HSCT (range, 12~27) and untransfused platelet count over 20,000/microliter after median 21 days of HSCT (range, 13~67). Six patients (24%, grade I : 3, II : 1, III : 1, IV : 1) developed acute GVHD and 8 (32%, limited : 4, extensive : 4) developed chronic GVHD. Hepatic venoocclusive disease (VOD) occurred in 2 patients (8%). Rejection occured in 4 patients (16 %), but among 22 allogeneic transplant recipients from HLA matched siblings, only one (5%) lost graft. After a median follow-up of 32 months (range 9~120 months), 5 year overall survival of all patients was 87%, and that of 22 allogeneic recipients from HLA matched sibling donors was 95%. Four patients (16%) died. Causes of death were VOD in one case, rejection with pneumonia one, acute GVHD one. One died from traffic accident in a cured state. CONCLUSION: Experiences from our center suggest that HSCT is an effective treatment for patients with severe aplastic anemia. Long- term survival is especially excellent for patients who have matched related donors.
