title: Treatment of acquired severe aplastic anemia: bone marrow transplantation compared with immunosuppressive therapy--The European Group for Blood and Marrow Transplantation experience.
abstract: Patients with severe aplastic anemia (SAA) can be successfully treated with bone marrow transplantation (BMT) or immunosuppressive therapy (IS). The current outcome using both forms of therapy among 3,669 patients treated in Europe between 1976 and 1998 is reviewed. Significant progress has been made and the overall risk of failure is now low, with survival rates greater than 80% for both treatments. Chronic graft-versus-host disease (GvHD) remains a problem for BMT patients, and carries a high risk of lethal complications. On the other hand, IS patients are exposed to late failure due to relapse or clonal/malignant diseases. First-line BMT from identical siblings is compared with IS therapy in an intent-to-treat analysis of 1,765 patients, regardless of subsequent transplant status. The outcome of SAA patients has improved considerably over time and is influenced by patient variables such as severity of the disease and age, but also by the choice of the initial treatment.
authors.affiliation: Working Party on Severe Aplastic Anemia of the European Blood and Marrow Transplantation Group and the Medical Statistical Department, University of Leiden, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: R
authors.initials: R
authors.lastname: Brand
authors.forename: R
authors.initials: R
authors.lastname: Oneto
authors.forename: B
authors.initials: B
authors.lastname: Bruno
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.forename: J
authors.initials: J
authors.lastname: Passweg
authors.forename: A
authors.initials: A
authors.lastname: Locasciulli
authors.forename: M T
authors.initials: MT
authors.lastname: Van Lint
authors.forename: A
authors.initials: A
authors.lastname: Tichelli
authors.forename: S
authors.initials: S
authors.lastname: McCann
authors.forename: J
authors.initials: J
authors.lastname: Marsh
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
authors.forename: J
authors.initials: J
authors.lastname: Hows
authors.forename: P
authors.initials: P
authors.lastname: Marin
authors.forename: H
authors.initials: H
authors.lastname: Schrezenmeier
mesh_terms: D000741:Anemia, Aplastic / Q000628:therapy*; D016026:Bone Marrow Transplantation; D005060:Europe; D006086:Graft vs Host Disease; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D019172:Transplantation Conditioning; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents