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01-08-2016 | Progress in Hematology

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

Authors: Andrea Bacigalupo, Sabrina Giammarco, Simona Sica

Published in: International Journal of Hematology | Issue 2/2016

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.

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Title: Bone marrow transplantation versus immunosuppressive therapy in patients with acquired severe aplastic anemia
Authors: Andrea Bacigalupo
Sabrina Giammarco
Simona Sica
Publication date: 01-08-2016
Publisher: Springer Japan
Published in: International Journal of Hematology / Issue 2/2016
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI: https://doi.org/10.1007/s12185-016-2037-8

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