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Allografting

Recent improvement in outcome of unrelated donor transplantation for aplastic anemia

Bone Marrow Transplantation volume 41, pages 45–50 (2008)Cite this article

Abstract

The aim was to determine whether outcome of unrelated donor transplantation for severe aplastic anemia has improved in recent years and whether this is due to patient selection or better transplant technology. We analyzed 498 patients transplanted during 1990–2005. By running univariate regression models dichotomizing year of transplantation we defined 1998 as the year of the most significant change in survival. Five-year survival increased from 32±8% before 1998 to 57±8% after 1998 (P<0.0001). When comparing the cohort before (n=149) and after 1998 (n=349), there were no differences except for older age, and more frequent use of PBSCs, after 1998. High-resolution HLA typing data were unavailable. After 1998, there was less graft failure (11 vs 26%, P<0.0001), less acute GvHD (cumulative incidence 28 vs 37%, P=0.02) and less chronic GvHD (22 vs 38%, P=0.004). In multivariate analyses adjusting for differences in age, HLA-mismatch, performance score and time to transplantation, there was no change in the year of transplant effect (relative risk of death in transplants after 1998: 0.44 (95% confidence interval 0.33–0.59)). There is no evidence for patient selection to explain significantly improved survival in patients transplanted after 1998. We speculate that this is due to better donor matching.

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Acknowledgements

This study was supported by the Stiftung für Hämatologische Forschung, Basel, Switzerland.

Author information

Authors and Affiliations

  1. Universit,

    R Viollier

  2. ä,

    R Viollier

  3. tskliniken Basel, Basel, Switzerland

    R Viollier

  4. Department of Hematology, Hopital Saint Louis, Paris, France

    G Socié

  5. Department of Hematology, University Hospital, Basel, Switzerland

    A Tichelli

  6. Department of Hematology, Azienda Ospedaliera Universitaria San Martino, Genova, Italy

    A Bacigalupo, R Oneto & M T van Lint

  7. Department of Pediatric Hemato-oncology and Stem Cell Transplantation, Leiden University, Leiden, The Netherlands,

    E T Korthof

  8. Department of Haematology, St George's Hospital, St George's University of London, London, UK

    J Marsh

  9. Oncology Unit, Royal Hospital for Sick Children, Bristol, UK

    J Cornish

  10. Department of Hematology, Karolinska University Hospital/Huddinge, Stockholm, Sweden

    P Ljungman

  11. Department of Pediatrics–BMT, Univ Hosp Lund, Lund, Sweden

    A N Békássy

  12. Dr von Hannersches Kinderspital, Muenchen, Germany

    M Fuehrer

  13. Department of Hematology, Hopital H Mondor, Creteil, France

    S Maury

  14. Universitaetsklinikum Ulm, Ulm, Germany

    H Schrezenmeier

  15. Department of Pediatric Hematology/Oncology and BMT, Wroclaw Medical University, Wroclaw, Poland

    D Wojcik

  16. San Camillo Forlanini Roma, Rome, Italy

    A Locasciulli

  17. Department of Hematology, Geneva University Hospital, Geneva, Switzerland

    J R Passweg

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  1. R Viollier
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for the Working Party on Severe Aplastic Anemia (WPSAA) of the European Group for Blood and Marrow Transplantation (EBMT)

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Correspondence to J R Passweg.

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Viollier, R., Socié, G., Tichelli, A. et al. Recent improvement in outcome of unrelated donor transplantation for aplastic anemia. Bone Marrow Transplant 41, 45–50 (2008). https://doi.org/10.1038/sj.bmt.1705894

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  • DOI: https://doi.org/10.1038/sj.bmt.1705894

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