UNRELATED TRANSPLANT FOR SEVERE APLASTIC ANEMIA (SAA): LONG TERM RESULTS AND RISK FACTOR ANALYSIS FOR OVERALL SURVIVAL
(Abstract release date: 05/19/16)
EHA Library. Moreira Funke V. 06/09/16; 133054; E1505
Disclosure(s): no disclosures
Prof. Vaneuza Araújo Moreira Funke
Contributions
Contributions
Abstract
Abstract: E1505
Type: Eposter Presentation
Background
For patients with SAA, Transplantation from an unrelated donor (UD) is usually considered after failure of at least one course of immunessupression. This strategy is based on a relatively high risk of complications for UD transplant recipients, such as graft rejection, graft-versus-host disease (GvHD) and infections. However, the outcome of unrelated donor transplants has significantly improved in recent years, due to better donor selection, conditioning regimen otimization and better supportive care.
Aims
The authors aim to describe results from 51 patients with SAA who have received unrelated allogeneic transplants in a single reference institution from 1997 to 2014 and identify risk factors for survival.
Methods
Data of 51 patients were retrieved from the center databasis. Fisher exact test was used for categoric variables and Kaplan Meier for survival estimates. P level of significance was < 0,05. Primary endpoint was overall survival. Secondary endpoints were engraftment, acute and chronic gvhd and identification of risk factors for survival.
Results
There were 30 females and 21 males. Median age was 15 years old (0-47). Median total number of cells infused was 3,4 x 108/kg.61% of the patients have received more than 50 transfusions previously. Conditioning regimen were: CY 120 + TBI 1320 +/- ATG in 16 (31%) patients, Bu 12 mg/kg+ Cy 120+ ATG in 18 (35%), and Fludarabine + Cy+ATG in 8 (16%), Fludarabine, Cy+TBI 200 in 9 (18%) patients. Stem cell source was marrow in 84%, cord blood in 13% and peripheral blood in 3% of patients. Transplants were full matched in 32 (62%) patients, had one mismatch (out of 12) in 12 (24%) and 2 mismatches in 7 (14%) patients. Engraftment was complete as evaluated by donor chimerism at day 30 and 100 post transplant in 36 patients (71%), partial in 4 (8%) and graft failure was observed in 9 (18%) patients. Acute GVHD grade II-IV was seen in 9 patients ( 18%) and NIH moderate to severe chronic GVHD was seen in 8 (16%) patients. Median overall survival was 328 days (4-4287) and estimated 5 years overall survival was 55%. Risk factors for survival identified were: HLA mismatch and stem cell sources other than marrow.
Conclusion
Unrelated transplants are a feasible salvage therapy for patients with SAA refractory to immunessupression, being HLA compatibility and marrow stem cell source factors with a positive impact on survival.
Session topic: E-poster
Keyword(s): Aplastic anemia, Stem cell transplant
Type: Eposter Presentation
Background
For patients with SAA, Transplantation from an unrelated donor (UD) is usually considered after failure of at least one course of immunessupression. This strategy is based on a relatively high risk of complications for UD transplant recipients, such as graft rejection, graft-versus-host disease (GvHD) and infections. However, the outcome of unrelated donor transplants has significantly improved in recent years, due to better donor selection, conditioning regimen otimization and better supportive care.
Aims
The authors aim to describe results from 51 patients with SAA who have received unrelated allogeneic transplants in a single reference institution from 1997 to 2014 and identify risk factors for survival.
Methods
Data of 51 patients were retrieved from the center databasis. Fisher exact test was used for categoric variables and Kaplan Meier for survival estimates. P level of significance was < 0,05. Primary endpoint was overall survival. Secondary endpoints were engraftment, acute and chronic gvhd and identification of risk factors for survival.
Results
There were 30 females and 21 males. Median age was 15 years old (0-47). Median total number of cells infused was 3,4 x 108/kg.61% of the patients have received more than 50 transfusions previously. Conditioning regimen were: CY 120 + TBI 1320 +/- ATG in 16 (31%) patients, Bu 12 mg/kg+ Cy 120+ ATG in 18 (35%), and Fludarabine + Cy+ATG in 8 (16%), Fludarabine, Cy+TBI 200 in 9 (18%) patients. Stem cell source was marrow in 84%, cord blood in 13% and peripheral blood in 3% of patients. Transplants were full matched in 32 (62%) patients, had one mismatch (out of 12) in 12 (24%) and 2 mismatches in 7 (14%) patients. Engraftment was complete as evaluated by donor chimerism at day 30 and 100 post transplant in 36 patients (71%), partial in 4 (8%) and graft failure was observed in 9 (18%) patients. Acute GVHD grade II-IV was seen in 9 patients ( 18%) and NIH moderate to severe chronic GVHD was seen in 8 (16%) patients. Median overall survival was 328 days (4-4287) and estimated 5 years overall survival was 55%. Risk factors for survival identified were: HLA mismatch and stem cell sources other than marrow.
Conclusion
Unrelated transplants are a feasible salvage therapy for patients with SAA refractory to immunessupression, being HLA compatibility and marrow stem cell source factors with a positive impact on survival.
Session topic: E-poster
Keyword(s): Aplastic anemia, Stem cell transplant
Abstract: E1505
Type: Eposter Presentation
Background
For patients with SAA, Transplantation from an unrelated donor (UD) is usually considered after failure of at least one course of immunessupression. This strategy is based on a relatively high risk of complications for UD transplant recipients, such as graft rejection, graft-versus-host disease (GvHD) and infections. However, the outcome of unrelated donor transplants has significantly improved in recent years, due to better donor selection, conditioning regimen otimization and better supportive care.
Aims
The authors aim to describe results from 51 patients with SAA who have received unrelated allogeneic transplants in a single reference institution from 1997 to 2014 and identify risk factors for survival.
Methods
Data of 51 patients were retrieved from the center databasis. Fisher exact test was used for categoric variables and Kaplan Meier for survival estimates. P level of significance was < 0,05. Primary endpoint was overall survival. Secondary endpoints were engraftment, acute and chronic gvhd and identification of risk factors for survival.
Results
There were 30 females and 21 males. Median age was 15 years old (0-47). Median total number of cells infused was 3,4 x 108/kg.61% of the patients have received more than 50 transfusions previously. Conditioning regimen were: CY 120 + TBI 1320 +/- ATG in 16 (31%) patients, Bu 12 mg/kg+ Cy 120+ ATG in 18 (35%), and Fludarabine + Cy+ATG in 8 (16%), Fludarabine, Cy+TBI 200 in 9 (18%) patients. Stem cell source was marrow in 84%, cord blood in 13% and peripheral blood in 3% of patients. Transplants were full matched in 32 (62%) patients, had one mismatch (out of 12) in 12 (24%) and 2 mismatches in 7 (14%) patients. Engraftment was complete as evaluated by donor chimerism at day 30 and 100 post transplant in 36 patients (71%), partial in 4 (8%) and graft failure was observed in 9 (18%) patients. Acute GVHD grade II-IV was seen in 9 patients ( 18%) and NIH moderate to severe chronic GVHD was seen in 8 (16%) patients. Median overall survival was 328 days (4-4287) and estimated 5 years overall survival was 55%. Risk factors for survival identified were: HLA mismatch and stem cell sources other than marrow.
Conclusion
Unrelated transplants are a feasible salvage therapy for patients with SAA refractory to immunessupression, being HLA compatibility and marrow stem cell source factors with a positive impact on survival.
Session topic: E-poster
Keyword(s): Aplastic anemia, Stem cell transplant
Type: Eposter Presentation
Background
For patients with SAA, Transplantation from an unrelated donor (UD) is usually considered after failure of at least one course of immunessupression. This strategy is based on a relatively high risk of complications for UD transplant recipients, such as graft rejection, graft-versus-host disease (GvHD) and infections. However, the outcome of unrelated donor transplants has significantly improved in recent years, due to better donor selection, conditioning regimen otimization and better supportive care.
Aims
The authors aim to describe results from 51 patients with SAA who have received unrelated allogeneic transplants in a single reference institution from 1997 to 2014 and identify risk factors for survival.
Methods
Data of 51 patients were retrieved from the center databasis. Fisher exact test was used for categoric variables and Kaplan Meier for survival estimates. P level of significance was < 0,05. Primary endpoint was overall survival. Secondary endpoints were engraftment, acute and chronic gvhd and identification of risk factors for survival.
Results
There were 30 females and 21 males. Median age was 15 years old (0-47). Median total number of cells infused was 3,4 x 108/kg.61% of the patients have received more than 50 transfusions previously. Conditioning regimen were: CY 120 + TBI 1320 +/- ATG in 16 (31%) patients, Bu 12 mg/kg+ Cy 120+ ATG in 18 (35%), and Fludarabine + Cy+ATG in 8 (16%), Fludarabine, Cy+TBI 200 in 9 (18%) patients. Stem cell source was marrow in 84%, cord blood in 13% and peripheral blood in 3% of patients. Transplants were full matched in 32 (62%) patients, had one mismatch (out of 12) in 12 (24%) and 2 mismatches in 7 (14%) patients. Engraftment was complete as evaluated by donor chimerism at day 30 and 100 post transplant in 36 patients (71%), partial in 4 (8%) and graft failure was observed in 9 (18%) patients. Acute GVHD grade II-IV was seen in 9 patients ( 18%) and NIH moderate to severe chronic GVHD was seen in 8 (16%) patients. Median overall survival was 328 days (4-4287) and estimated 5 years overall survival was 55%. Risk factors for survival identified were: HLA mismatch and stem cell sources other than marrow.
Conclusion
Unrelated transplants are a feasible salvage therapy for patients with SAA refractory to immunessupression, being HLA compatibility and marrow stem cell source factors with a positive impact on survival.
Session topic: E-poster
Keyword(s): Aplastic anemia, Stem cell transplant
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