Standard front-line treatment for acquired aplastic anemia (AA) for patients is either immunosuppressive therapy (IST) or bone marrow transplantation (BMT), usually from an HLA identical sibling. Whereas long-term survival is comparable with either treatment, important differences remain: IST patients may have incomplete or no recovery, are exposed to late clonal disorders and relapse of the original disease. Transplantation is a curative treatment, but patients are exposed to transplant-related complications both acute and chronic, such as chronic graft versus host disease (cGvHD). In the year 2000, a study by the European Group for Blood and Marrow Transplantation (EBMT), looked at failure free survival (FFS), in patients receiving first-line BMT from an HLA identical sibling, or the first-line IST. Young patients with low neutrophil counts benefited of the first-line BMT; the opposite was true for older patients with higher neutrophil counts; and a third intermediate group of patients had comparable survival irrespective of the first-line therapy. We have now studied a more recent cohort of patients to assess whether things have changed over the years. We have found similar results, although overall survival has improved, as a consequence of changes in the IST and BMT protocols.

Bacigalupo, A., Giammarco, S., Sica, S., Bone marrow transplantation versus immunosuppressive therapy in patients with acquired severe aplastic anemia, <<INTERNATIONAL JOURNAL OF HEMATOLOGY>>, 2016; 104 (2): 168-174. [doi:10.1007/s12185-016-2037-8] [http://hdl.handle.net/10807/92659]

Bone marrow transplantation versus immunosuppressive therapy in patients with acquired severe aplastic anemia

Bacigalupo, Andrea
;
Giammarco, Sabrina
Secondo
;
Sica, Simona
Ultimo
2016

Abstract

Standard front-line treatment for acquired aplastic anemia (AA) for patients is either immunosuppressive therapy (IST) or bone marrow transplantation (BMT), usually from an HLA identical sibling. Whereas long-term survival is comparable with either treatment, important differences remain: IST patients may have incomplete or no recovery, are exposed to late clonal disorders and relapse of the original disease. Transplantation is a curative treatment, but patients are exposed to transplant-related complications both acute and chronic, such as chronic graft versus host disease (cGvHD). In the year 2000, a study by the European Group for Blood and Marrow Transplantation (EBMT), looked at failure free survival (FFS), in patients receiving first-line BMT from an HLA identical sibling, or the first-line IST. Young patients with low neutrophil counts benefited of the first-line BMT; the opposite was true for older patients with higher neutrophil counts; and a third intermediate group of patients had comparable survival irrespective of the first-line therapy. We have now studied a more recent cohort of patients to assess whether things have changed over the years. We have found similar results, although overall survival has improved, as a consequence of changes in the IST and BMT protocols.
2016
Inglese
Bacigalupo, A., Giammarco, S., Sica, S., Bone marrow transplantation versus immunosuppressive therapy in patients with acquired severe aplastic anemia, <<INTERNATIONAL JOURNAL OF HEMATOLOGY>>, 2016; 104 (2): 168-174. [doi:10.1007/s12185-016-2037-8] [http://hdl.handle.net/10807/92659]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/92659
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