Marrow transplantation for severe aplastic anemia. Long-term outcome in fifty "untransfused" patients.

Published

Journal Article

Fifty patients with severe aplastic anemia had no transfusions of blood products until just before marrow transplantation from HLA-identical family members. Of the 50, 42 are still alive 1 to 12 years after transplantation (median, 7 years). By actuarial standards, the 10-year probability of survival is 82%. Of the 42 surviving patients, 37 have Karnofsky performance status scores of 100% and 5 with chronic graft-versus-host disease have scores ranging from 50% to 90% (median, 80%). The 8 deaths were caused by early infection in 1, graft rejection in 1, acute graft-versus-host disease in 3, and chronic graft-versus-host disease in 3. All deaths occurred within two years after transplantation. The incidence of graft failure was 10%. Acute graft-versus-host disease developed in 14 of 44 patients at risk and chronic graft-versus-host disease, in 15 of 41. Risk factors for development of chronic graft-versus-host disease included increased age (p = 0.008) and presence of acute graft-versus-host disease (p = 0.001). The only factor associated with increased risk of death was development of acute graft-versus-host disease (p = 0.05). Results of this study extend our previous finding that patients with severe aplastic anemia who have transplants before the onset of transfusion-induced sensitization have an excellent probability of long-term survival and a normal life.

Full Text

Duke Authors

Cited Authors

  • Anasetti, C; Doney, KC; Storb, R; Meyers, JD; Farewell, VT; Buckner, CD; Appelbaum, FR; Sullivan, KM; Clift, RA; Deeg, HJ

Published Date

  • April 1986

Published In

Volume / Issue

  • 104 / 4

Start / End Page

  • 461 - 466

PubMed ID

  • 3006565

Pubmed Central ID

  • 3006565

International Standard Serial Number (ISSN)

  • 0003-4819

Digital Object Identifier (DOI)

  • 10.7326/0003-4819-104-4-461

Language

  • eng

Conference Location

  • United States