title: High-dose immunosuppressive therapy combined with cord blood infusion and non-myeloablative peripheral blood stem cell transplantation for patients with severe aplastic anemia.
abstract: OBJECTIVE
  The aim of this study was to compare the clinical effective rates of high-dose immunosuppressive therapy combined with cord blood infusion (IS + CBI) and non-myeloablative peripheral blood stem cell transplantation (NSCT) for severe aplastic anemia (SAA).
  
  
  METHODS
  Human leukocyte antigen (HLA)-mismatched patients received immunosuppressive therapy combined with IS + CBI, whereas those with HLA matches received NSCT. Clinical effective rates, hematopoietic recovery, and prevalence of complications were compared between the two groups.
  
  
  RESULTS
  No significant difference in total effective rate or 2 years long-term survival was observed between the two groups. The total effective treatment in the NSCT, IS + CBI group was 80%, 68.75%, and the 2 years long-term survival rate in two groups was 2 years 76.66%, 68.75%, respectively. The median times of WBC > 1.0×109/L in the NSCT group was faster than that of IS + CBI group (13 vs 19 days) (p = 0.027). The median recovery times of PLT and Hb in the NSCT group was significantly faster than that of IS + CBI group (19 vs 50 days) (p = 0.00), (27 vs 57 days) (p = 0.001). The SAA group and the very SAA (VSAA) group did not show a significant difference in effective rate (76.74% vs 68.42%) (p = 0.490). In the NSCT group, two preparative regimens did not show a significant difference in effect (70.59% vs 92.31%) (p = 0.141).
  
  
  CONCLUSIONS
  IS + CBI is applicable to HLA-mismatched patients with SAA. NSCT is the treatment of choice for patients with HLA matching alleles. Both treatment methods are effective on VSAA.
authors.affiliation: Department of Hematology, Qilu Hospital of Shandong University, Jinan, Shandong, China. jijisos@sina.com.
authors.forename: Z
authors.initials: Z
authors.lastname: Yu
authors.forename: F
authors.initials: F
authors.lastname: Zhou
authors.forename: L
authors.initials: L
authors.lastname: -Fu Ge
authors.forename: X-M
authors.initials: XM
authors.lastname: Liu
authors.forename: Y
authors.initials: Y
authors.lastname: Fang
authors.forename: L
authors.initials: L
authors.lastname: Xie
authors.forename: F-S
authors.initials: FS
authors.lastname: Kong
authors.forename: N-X
authors.initials: NX
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation
chemical_list: D007166:Immunosuppressive Agents