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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2000-5-4
pubmed:abstractText
We have analyzed 2,002 patients grafted in Europe between 1976 and 1998 from an identical twin (n = 34), from an HLA-identical sibling (n = 1,699) or from an alternative donor (n = 269), which included unrelated and family mismatched donors. The proportions of patients surviving in these three groups are, respectively, 91, 66 and 37%: major causes of failure were acute graft-versus host disease (GvHD) (11%), infection (12%), pneumonitis (4%), rejection (4%). In multivariate Cox analysis, factors predicting outcome were patient's age (p < 0.0001), donor type (p < 0.0001), interval between diagnosis and bone marrow transplantation (BMT) (p < 0.0005), year of BMT (p = 0.0005) and female donor for a male recipient (p = 0.02). Patients were then divided in two groups according to the year of BMT: up to or after 1990. The overall death rate dropped from 43 to 24% (p < 0.00001). Improvements were seen mostly for grafts from identical siblings (from 54 to 75%, p < 0.0001), and less so for alternative-donor grafts (from 28 to 35%; p = 0.07). Major changes have occurred in the BMT protocol: decreasing use of radiotherapy in the conditioning regimen (from 35 to 24%; p < 0.0001) and increasing use of cyclosporin (with or without methotrexate) for GvHD prophylaxis (from 70 to 98%; p < 0.0001). In conclusion, the outcome of allogeneic BMT for patients with severe aplastic anemia has considerably improved over the past two decades: young patients, grafted early after diagnosis from an identical sibling, have currently an over 80% chance of long-term survival. Transplants from twins are very successful as well. The risk of complications with alternative donor transplants is still high.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
0001-5792
pubmed:author
pubmed:copyrightInfo
Copyright 2000 S. Karger AG, Basel
pubmed:issnType
Print
pubmed:volume
103
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
19-25
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:10705155-Acute Disease, pubmed-meshheading:10705155-Adolescent, pubmed-meshheading:10705155-Adult, pubmed-meshheading:10705155-Age Factors, pubmed-meshheading:10705155-Aged, pubmed-meshheading:10705155-Anemia, Aplastic, pubmed-meshheading:10705155-Bone Marrow Transplantation, pubmed-meshheading:10705155-Child, pubmed-meshheading:10705155-Child, Preschool, pubmed-meshheading:10705155-Chronic Disease, pubmed-meshheading:10705155-Female, pubmed-meshheading:10705155-Graft Rejection, pubmed-meshheading:10705155-Graft vs Host Disease, pubmed-meshheading:10705155-Humans, pubmed-meshheading:10705155-Infant, pubmed-meshheading:10705155-Infection, pubmed-meshheading:10705155-Male, pubmed-meshheading:10705155-Middle Aged, pubmed-meshheading:10705155-Pneumonia, pubmed-meshheading:10705155-Survival Rate, pubmed-meshheading:10705155-Transplantation Conditioning
pubmed:year
2000
pubmed:articleTitle
Current results of bone marrow transplantation in patients with acquired severe aplastic anemia. Report of the European Group for Blood and Marrow transplantation. On behalf of the Working Party on Severe Aplastic Anemia of the European Group for Blood and Marrow Transplantation.
pubmed:affiliation
Second Department of Haemotology, Ospedale San Martino, Servizio Radioterapia IST, Genoa, Italy. apbacigalupo@smartino.ge.it
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't