09 August 2019 : Original article
Aplastic Anemia Preconditioned with Fludarabine, Cyclophosphamide, and Anti-Thymocyte Globulin
Dan Yang1BCDEG, Jianmin Yang1AF, Xiaoxia Hu1CF, Jie Chen1EF, Lei Gao1F, Hui Cheng1BC, Gusheng Tang1CD, Yanrong Luo1E, Weiping Zhang1ACDEF*, Jianmin Wang1ACEFGDOI: 10.12659/AOT.915696
Ann Transplant 2019; 24:461-471
Abstract
BACKGROUND: Graft rejection and graft versus host disease (GvHD) have impeded the success of hematopoietic cell transplantation for severe aplastic anemia (SAA) patients. There is no sufficient data to identify the outcomes of peripheral blood stem cell transplantation (PBSCT) in SAA patients, especially for adult SAA patients. The aim of this study was to evaluate the outcomes of adult SAA patients undergoing PBSCT with the FCA regimen. The FCA regimen includes fludarabine, cyclophosphamide, and anti-thymocyte globulin (ATG).
MATERIAL AND METHODS: We report our experience with 46 adult SAA patients who underwent PBSCT with the FCA regimen. Thirty SAA patients who received only cyclophosphamide and ATG (CA) regimen were used as controls. Complications and survival outcomes were evaluated and compared.
RESULTS: There was a significantly higher percentage of patients who achieved >95% donor chimerism by day 30 in the FCA group. The 5-year event-free survival (EFS) rate in the FCA group was higher than that in the CA group (95.4% versus 73.3%). In addition, the 5-year rejection rate (RR) in the FCA group was lower than that in the CA group (4.6% versus 23.6%). A multivariable model identified the FCA regimen as an independent factor affecting EFS and RR. However, GvHD and serious infection did not differ between the 2 groups. For patients with an unrelated donor, the FCA regimen had a higher EFS and a lower RR than the CA regimen.
CONCLUSIONS: The FCA regimen for PBSCT in adult SAA patients compared favorably to the CA regimen. It can improve EFS and reduce graft rejection, especially for unrelated donor PBSCT.
Keywords: Anemia, Aplastic, Antineoplastic Combined Chemotherapy Protocols, Peripheral Blood Stem Cell Transplantation, Adolescent, Antilymphocyte Serum, Cyclophosphamide, Transplantation Conditioning, Vidarabine, young adult
In Press
Original article
Simultaneous Liver and Kidney Transplant in a Middle-Income Country: A Single-Center ExperienceAnn Transplant In Press; DOI: 10.12659/AOT.947649
Original article
Outcomes of Combined Liver-Kidney Transplantation in Polycystic Liver and Kidney DiseaseAnn Transplant In Press; DOI: 10.12659/AOT.947639
Most Viewed Current Articles
03 Jan 2023 : Original article 6,872
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...DOI :10.12659/AOT.938467
Ann Transplant 2023; 28:e938467
15 Aug 2023 : Review article 6,817
Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ TransplantationDOI :10.12659/AOT.939750
Ann Transplant 2023; 28:e939750
16 May 2023 : Original article 6,561
Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...DOI :10.12659/AOT.939258
Ann Transplant 2023; 28:e939258
28 May 2024 : Original article 5,900
Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...DOI :10.12659/AOT.943281
Ann Transplant 2024; 29:e943281