Allogeneic hematopoietic cell transplantation without total body irradiation from unrelated donor in adult patients with idiopathic aplastic anemia: Fludarabine versus cyclophosphamide-ATG
- Authors
- Kim, Hawk; Lee, Kyoo-Hyung; Kim, Inho; Sohn, Sang Kyun; Jung, Chul Won; Joo, Young Don; Kim, Sung-Hyun; Kim, Byung Soo; Choi, Jung Hye; Kwak, Jae-Yong; Kim, Min Kyoung; Bae, Sung Hwa; Shin, Ho Jin; Won, Jong-Ho; Lee, Won Sik; Oh, Sukjoong; Kim, Hyo Jung; Park, Jae-Hoo
- Issue Date
- Jul-2014
- Publisher
- PERGAMON-ELSEVIER SCIENCE LTD
- Keywords
- Unrelated donor; Total body irradiation; Aplastic anemia; Allogeneic hematopoietic stem cell transplantation; Fludarabinea
- Citation
- LEUKEMIA RESEARCH, v.38, no.7, pp.730 - 736
- Indexed
- SCIE
SCOPUS
- Journal Title
- LEUKEMIA RESEARCH
- Volume
- 38
- Number
- 7
- Start Page
- 730
- End Page
- 736
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/159634
- DOI
- 10.1016/j.leukres.2014.01.002
- ISSN
- 0145-2126
- Abstract
- Total body irradiation (TBI) has traditionally been used in the conditioning regimen for allogenetic hematopoietic stem cell transplantation (alloHCT) from an unrelated donor (u-HCT). However, patients are increasingly receiving a fludarabine-based conditioning regimen without TBI, as it seemed less toxic than TBI. We need to know the clinical results of non-TBI u-HCT treatments. We retrospectively investigated the clinical outcomes of allogenetic hematopoietic cell transplantation (alloHCT) from an unrelated donor without TBI (non-TBI u-HCT) and compared the clinical outcomes of fludarabine-based (FLU group) and cyclophosphamide-ATG (Cy-ATG group) conditioning regimens. Sixty-one patients received the non-TBI conditioning regimen for u-HCT (32 in the FLU group and 29 in the Cy-ATG group). The cumulative incidence of neutrophil engraftment at 30 days, platelet > 20 K/mu L at 30 days, acute graft-versus host disease (aGvHD) at 100 days, and chronic GvHD (cGvHD) at 2 years were 87.01%, 65.57%, 35.20%, and 26.64%, respectively. However, transplantation outcomes and overall survival rates did not differ between the FLU and Cy-ATG groups. Only infused CD34+ cells >3 x 10(6) kg(-1) was identified as a favorable factor for survival in the multivariate analysis. In conclusion, non-TBI u-HCT was feasible and there was no difference between the FLU and Cy-ATG groups in terms of transplantation outcomes.
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