title: Survival of patients with documented autologous recovery after SCT for severe aplastic anemia: a study by the WPSAA of the EBMT.
abstract: Graft rejection, with persistent pancytopenia, is well documented after allogeneic BMT (hematopoietic SCT (HSCT)) for severe aplastic anemia (SAA) and the prognosis is poor. The recovery of host-hematopoiesis, autologous recovery (AR), after allogeneic HSCT is a rare event and the incidence and long-term survival are unknown. We report a retrospective analysis of consecutive patients in the Aplastic Anaemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT-WPSAA) registry between 1973 and 2005. A total of 45 cases of AR, of 1205 patients transplanted for SAA in 57 centers are reported. We describe characteristics and long-term outcome of patients with AR, compared with SAA patients from participating transplant centers without AR (n=1024) and patients with graft rejection (n=136) without autologous recovery. The estimated cumulative incidence of AR was 4.2% (3.1-5.6) (confidence interval (CI) 95%) with an OS of 84% (95% CI 83-107%). The OS of the control group was 74% (81-90) at 10 years of follow up, whereas the patients with graft failure had an OS of 16% (CI 12-28%). This retrospective analysis establishes the incidence and long-term survival of patients experiencing AR after allogeneic HSCT for SAA.
authors.affiliation: Haematology Department, St James's Hospital, Trinity College Dublin, Dublin, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Piccin
authors.forename: S
authors.initials: S
authors.lastname: McCann
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.forename: R
authors.initials: R
authors.lastname: Oneto
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.forename: A
authors.initials: A
authors.lastname: Locasciulli
authors.forename: J
authors.initials: J
authors.lastname: Marsh
authors.forename: H
authors.initials: H
authors.lastname: Schrezenmeier
authors.forename: A
authors.initials: A
authors.lastname: Tichelli
authors.forename: E
authors.initials: E
authors.lastname: Hand
authors.forename: M
authors.initials: M
authors.lastname: Lawler
authors.forename: J
authors.initials: J
authors.lastname: Passweg
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006086:Graft vs Host Disease; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000401:mortality* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D010198:Pancytopenia; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors / Q000706:statistics & numerical data; D055815:Young Adult