Outpatient ATG-free hematopoietic transplantation for aplastic anemia in limited-resource environments offers excellent results: Data from a single LATAM center

IF 2.1 4区 医学 Q3 HEMATOLOGY
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引用次数: 0

Abstract

Objective

To document the results of outpatient hematopoietic stem cell transplantation (HSCT) from the peripheral blood (PB) of sibling donors without anti-thymocyte globulin (ATG) in the conditioning regimen.

Material and methods

Patients from a low-income population with severe AA who received a PB, unmanipulated sibling HLA-identical HSCT between 2000 and 2020 at a single institution were studied. Survival was the primary outcome.

Results

Forty-one transplants were performed. Time between diagnosis and transplant was five months (1–104). Median age was 37 (range, 4–61) years; 25 (61 %) recipients were males and 32 (78 %) had treatment failure, 9 (22 %) have not received treatment. ATG was administered in 5 (12.2 %) cases; the graft source was PB in 38 (92.7 %) transplants. Twenty-six (63.4 %) transplants were carried out in the outpatient setting. Infections developed in 14 (34.1 %) patients. Primary graft failure (GF) occurred in 3 (7.3 %) patients. The 15-year OS was 81 %, EFS was 77.4 %. Patients with high pre-HSCT transfusion burden had lower OS (p = 0.035) and EFS (p = 0.026). Previous treatment failure and age were not associated with lower OS (p = 0.115, p = 0.069) or EFS (p = 0.088, p = 0.5, respectively).

Conclusions

HLA-identical T-cell replete outpatient HSCT from the PB of sibling donors for AA patients using ATG-free conditioning offers excellent long-term survival.

在资源有限的环境中,门诊无ATG造血移植治疗再生障碍性贫血效果极佳:来自拉丁美洲和加勒比海地区一家中心的数据
材料与方法研究了2000年至2020年间在一家医疗机构接受外周血(PB)、无人工配型的同胞HLA相同造血干细胞移植的低收入重症AA患者。结果共进行了 41 例移植。从诊断到移植的时间为5个月(1-104)。中位年龄为 37 岁(4-61 岁);25 例(61%)受者为男性,32 例(78%)治疗失败,9 例(22%)未接受治疗。5例(12.2%)接受了ATG治疗;38例(92.7%)接受了PB移植。26例(63.4%)移植在门诊进行。14例(34.1%)患者发生了感染。3例(7.3%)患者出现原发性移植失败(GF)。15年的OS为81%,EFS为77.4%。HSCT前输血负担较重的患者OS(p = 0.035)和EFS(p = 0.026)较低。结论使用无ATG调理的AA患者从同胞供者血浆中获得的HLA-同源T细胞门诊造血干细胞移植可提供极佳的长期生存率。
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来源期刊
CiteScore
4.90
自引率
0.00%
发文量
42
审稿时长
14 days
期刊介绍: Blood Cells, Molecules & Diseases emphasizes not only blood cells, but also covers the molecular basis of hematologic disease and studies of the diseases themselves. This is an invaluable resource to all those interested in the study of hematology, cell biology, immunology, and human genetics.
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