TY - JOUR
T1 - Allogeneic Hematopoietic Cell Transplantation in Patients aged 50 years or older with Severe Aplastic Anemia
AU - Rice, C.
AU - Eikema, D.J.
AU - Marsh, J.C.W.
AU - Knol, C.
AU - Hebert, K.
AU - Putter, H.
AU - Peterson, E.
AU - Deeg, H.-J.
AU - Halkes, C.J.M.
AU - Pidala, J.
AU - Anderlini, P.
AU - Tischer, J.
AU - Kroger, N.
AU - McDonald, A.
AU - Antin, J.H.
AU - Schaap, N.P.M.
AU - Hallek, M.
AU - Einsele, H.
AU - Mathews, V.
AU - Kapoor, N.
AU - Boelens, J.J.
AU - Mufti, G.J.
AU - Potter, V.
AU - Pefault de la Tour, R.
AU - Eapen, M.
AU - Dufour, C.
PY - 2018/9/5
Y1 - 2018/9/5
N2 - We report on 499 patients with severe aplastic anemia aged ≥50 years who underwent hematopoietic cell transplantation (HCT) from HLA-matched sibling (n=275), or HLA-matched (8/8) unrelated donors (n=39187) between 2005 and 2016. The median age at HCT was 57.8 years; 16% of patients were 65-77 years old. Multivariable analysis confirmed higher mortality risks for patients with performance score less than 90% (HR 1.41 (1.03-1.92), p=0.03) and after unrelated donor transplantation (HR 1.47 (1-2.16), p=0.05). The 3-year probabilities of survival for patients with performance score 90-100 and less than 90 after HLA-matched sibling transplant were 66% (57-75%) and 57% (47-76%), respectively. The corresponding probabilities after HLA-matched unrelated donor transplantation were 57% (48-67%) and 48% (36-59%). Age at transplantation was not associated with survival but grade II-IV acute GVHD risks were higher for patients aged 65 years or older (sHR 1.7 (1.07-2.72), p=0.026). Chronic GVHD was lower with GVHD prophylaxis regimens calcineurin inhibitor (CNI) + methotrexate (sHR 0.52 (0.33-0.81), p=0.004) and CNI alone or other agents (sHR 0.27 (0.14-0.53), p
AB - We report on 499 patients with severe aplastic anemia aged ≥50 years who underwent hematopoietic cell transplantation (HCT) from HLA-matched sibling (n=275), or HLA-matched (8/8) unrelated donors (n=39187) between 2005 and 2016. The median age at HCT was 57.8 years; 16% of patients were 65-77 years old. Multivariable analysis confirmed higher mortality risks for patients with performance score less than 90% (HR 1.41 (1.03-1.92), p=0.03) and after unrelated donor transplantation (HR 1.47 (1-2.16), p=0.05). The 3-year probabilities of survival for patients with performance score 90-100 and less than 90 after HLA-matched sibling transplant were 66% (57-75%) and 57% (47-76%), respectively. The corresponding probabilities after HLA-matched unrelated donor transplantation were 57% (48-67%) and 48% (36-59%). Age at transplantation was not associated with survival but grade II-IV acute GVHD risks were higher for patients aged 65 years or older (sHR 1.7 (1.07-2.72), p=0.026). Chronic GVHD was lower with GVHD prophylaxis regimens calcineurin inhibitor (CNI) + methotrexate (sHR 0.52 (0.33-0.81), p=0.004) and CNI alone or other agents (sHR 0.27 (0.14-0.53), p
U2 - 10.1016/j.bbmt.2018.08.029
DO - 10.1016/j.bbmt.2018.08.029
M3 - Article
SN - 1083-8791
JO - BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
JF - BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
ER -