Hepatitis-associated aplastic anaemia: epidemiology and treatment results obtained in Europe. A report of The EBMT aplastic anaemia working party.
In order to assess the epidemiology of Hepatitis-Associated Aplasia (HAA) and compare treatment outcome of HAA with non-HAA patients, we evaluated 3916 aplastic anaemia patients reported to the European Registry between 1990 and 2007. Year, month, season of diagnosis, type and outcome of first-line therapy were analysed. Prevalence of HAA (n = 214) in Europe was 5%. Compared to non-HAA patients, HAA patients were younger (15 vs. 20 years, P < 0.001), with a male prevalence (68% vs. 58% P = 0.002), and were treated earlier after diagnosis (46 vs. 62 d; P < 0.001). No significant differences were found regarding the year or month of diagnosis. No geographic clusters could be identified. Actuarial survival at 10 years after first-line immunosuppression was 69%, and did not differ according to aetiology. The 10-year actuarial survival after transplantation was 70%, and was comparable in HAA and non-HAA patients, when stratified for age and donor type. In a multivariate Cox analysis, increasing age and delayed treatment were significant negative indicators for survival. In conclusion, the incidence of HAA was 5% and was evenly distributed over time and geographic areas in Europe. Treatment outcome and predictive variables, were comparable in patients with or without HAA.
Locasciulli
Anna
A
Ematologia Pediatrica e Trapianto di Midollo, Ospedale San Camillo, Roma, Italy. alocasciulli@scamilloforlanini.rm.it
Bacigalupo
Andrea
A
Bruno
Barbara
B
Montante
Barbara
B
Marsh
Judith
J
Tichelli
André
A
Socié
Gerard
G
Passweg
Jakob
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000741:Anemia, Aplastic / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005060:Europe / Q000453:epidemiology; D005260:Female; D006505:Hepatitis / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents