Allogeneic hematopoietic cell transplantation without total body irradiation from unrelated donor in adult patients with idiopathic aplastic anemia: fludarabine versus cyclophosphamide-ATG.
Total body irradiation (TBI) has traditionally been used in the conditioning regimen for allogenetic hematopoietic stem cell transplantation (alloHCT) from an unrelated donor (u-HCT). However, patients are increasingly receiving a fludarabine-based conditioning regimen without TBI, as it seemed less toxic than TBI. We need to know the clinical results of non-TBI u-HCT treatments. We retrospectively investigated the clinical outcomes of allogenetic hematopoietic cell transplantation (alloHCT) from an unrelated donor without TBI (non-TBI u-HCT) and compared the clinical outcomes of fludarabine-based (FLU group) and cyclophosphamide-ATG (Cy-ATG group) conditioning regimens. Sixty-one patients received the non-TBI conditioning regimen for u-HCT (32 in the FLU group and 29 in the Cy-ATG group). The cumulative incidence of neutrophil engraftment at 30 days, platelet>20K/μL at 30 days, acute graft-versus host disease (aGvHD) at 100 days, and chronic GvHD (cGvHD) at 2 years were 87.01%, 65.57%, 35.20%, and 26.64%, respectively. However, transplantation outcomes and overall survival rates did not differ between the FLU and Cy-ATG groups. Only infused CD34+ cells >3×10(6)kg(-1) was identified as a favorable factor for survival in the multivariate analysis. In conclusion, non-TBI u-HCT was feasible and there was no difference between the FLU and Cy-ATG groups in terms of transplantation outcomes.
Ulsan University Hospital, 877 Baneojinsunwhan-doro, Ulsan, Republic of Korea. Electronic address: kimhawkmd@gmail.com.
Hawk
H
Kim
Asan Medical Center, 86 Asanbyeongwon-gil, Seoul, Republic of Korea.
Kyoo-Hyung
KH
Lee
Seoul National University Hospital, 101 Daehang-ro, Seoul, Republic of Korea.
Inho
I
Kim
Kyungpook National University Hospital, 135, Dongdeok-ro, Daegu, Republic of Korea.
Sang Kyun
SK
Sohn
Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul, Republic of Korea.
Chul Won
CW
Jung
Inje University Haeundae Paik Hospital, 875 Haeundae-ro, Busan, Republic of Korea.
Young Don
YD
Joo
Dong-A University Medical Center, 26 Daesingongwon-ro, Busan, Republic of Korea.
Sung-Hyun
SH
Kim
Korea University Hospital Seoul Hospital, 73 Inchon-ro, Seoul, Republic of Korea.
Byung Soo
BS
Kim
Hanyang University Hospital, 222 Wangsimni-ro, Seoul, Republic of Korea.
Jung Hye
JH
Choi
Chonbuk National University Hospital, 20 Geonji-ro, Jeonju-si, Jeollabuk-do, Republic of Korea.
Jae-Yong
JY
Kwak
Yeungnam University Medical Center, 170 Hyeonchung-ro, Daegu, Republic of Korea.
Min Kyoung
MK
Kim
Daegu Catholic University Hospital, 33 Duryugongwon-ro 17-gil, Daegu, Republic of Korea.
Sung Hwa
SH
Bae
Pusan National University Hospital, 179 Gudeok-ro, Busan, Republic of Korea.
Ho Jin
HJ
Shin
Soonchunhyang University Seoul Hospital, 59 Dassagwan-ro, Seoul, Republic of Korea.
Jong-Ho
JH
Won
Inje University Busan Paik Hospital, 75 Bokji-ro, Busan, Republic of Korea.
Won Sik
WS
Lee
Kangbuk Samsung Hospital, 29 Saemunan-ro, Seoul, Republic of Korea.
Sukjoong
S
Oh
Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang, Republic of Korea. Electronic address: hemonc@hanmail.net.
Hyo Jung
HJ
Kim
Ulsan University Hospital, 877 Baneojinsunwhan-doro, Ulsan, Republic of Korea. Electronic address: jaehpark@uuh.ulsan.kr.
Jae-Hoo
JH
Park
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000401:mortality / Q000628:therapy*; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D002648:Child; D003520:Cyclophosphamide / Q000008:administration & dosage*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014916:Whole-Body Irradiation
D000961:Antilymphocyte Serum; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine
Allogeneic hematopoietic stem cell transplantation; Aplastic anemia; Fludarabine; Total body irradiation; Unrelated donor