Engraftment of heavily transfused patients with severe aplastic anemia with a fludarabine-based regimen.

Abstract:

:We have developed a practical conditioning regimen without anti-thymocyte globulin (ATG), irradiation, or other myeloablative alkylating agent for low-income countries in which patients with severe aplastic anemia (SAA), who usually have heavily transfused and a prolonged disease history. The application of ATG, Busulphan, and/or irradiation to cyclophosphamide (Cy) to avoid graft rejection has many short- and long-term complications. In this study, we focused on evaluating a fludarabine-based conditioning regimen, among 83 patients with SAA. Patients were treated with fludarabine (40 mg/m(2) /d; day [-5 to -2]) and cyclophosphamide (50 mg/kg/d; day [-5 to -2]). Altogether, 81 patients indicated initial engraftment, whereas two cases showed primary graft failure. And four of the 81 cases indicated graft rejection during follow-up. Regardless of a high cumulative incidence of acute (55/83; 66.2% grade II-IV; 47/83; 56.6% III-IV) and chronic graft-versus-host disease (50/83; 60.2%), in total, 77 patients showed durable engraftment and transfusion independence, and 64 are alive at a median time of 49 months with an overall survival rate of 66%. In conclusion, this conditioning indicated well toleration, mild toxicity, durable engraftment, excellent survival as well as less cost. Its application might shed new light on SAA at high risk of graft rejection in resource-limited countries.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Wang SB,Li L,Pan XH,Hu DM,Peng LH,Liu L,Xie ZJ,Yin B,Sun XJ,Yu J,Liang Y

doi

10.1111/ctr.12061

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

E109-15

issue

2

eissn

0902-0063

issn

1399-0012

journal_volume

27

pub_type

临床试验,杂志文章
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    更新日期:2008-09-01 00:00:00

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    更新日期:2002-06-01 00:00:00

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    journal_title:Clinical transplantation

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:

    authors:

    更新日期:1996-02-01 00:00:00

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    更新日期:1997-10-01 00:00:00

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    更新日期:2001-02-01 00:00:00

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    pub_type: 杂志文章

    doi:

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    pub_type: 杂志文章

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    更新日期:2012-03-01 00:00:00

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    pub_type: 杂志文章

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    更新日期:2010-11-01 00:00:00

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    pub_type: 临床试验,杂志文章

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    pub_type: 杂志文章

    doi:

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