Is it time for a change? The case for early application of unrelated allo-SCT for severe aplastic anemia.
Severe aplastic anemia (SAA) is a BM failure syndrome in which allo-SCT remains a highly effective curative option. Its application remains limited by donor availability and by the potential for treatment-related morbidity and mortality. The improved outcomes with unrelated transplantation are a result of the advent of molecular donor-recipient matching, generation of effective novel conditioning regimens, improvement of supportive care and expansion of the donor registry. Decision making regarding the earlier use of unrelated transplant procedures is rapidly evolving. This paper reviews critical data relevant to these treatment options and recommends early consideration of related SCT for patients with SAA who show failure of immune suppressive therapy.
Meyers
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Center for Hematologic Malignancies, Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97229, USA. meyersg@ohsu.edu
Maziarz
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RT
D000375:Aging; D000741:Anemia, Aplastic / Q000628:therapy*; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends*; D006650:Histocompatibility Testing / Q000639:trends; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D012720:Severity of Illness Index; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends; D019172:Transplantation Conditioning / Q000639:trends; D014184:Transplantation, Homologous; D016896:Treatment Outcome