Allogeneic hematopoietic cell transplantation without total body irradiation from unrelated donor in adult patients with idiopathic aplastic anemia: Fludarabine versus cyclophosphamide-ATG

Hawk Kim, Kyoo Hyung Lee, Inho Kim, Sang Kyun Sohn, Chul Won Jung, Young Don Joo, Sung Hyun Kim, Byung Soo Kim, Jung Hye Choi, Jae Yong Kwak, Min Kyoung Kim, Sung Hwa Bae, Ho Jin Shin, Jong Ho Won, Won Sik Lee, Sukjoong Oh, Hyo Jung Kim, Jae Hoo Park

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Abstract

Total body irradiation (TBI) has traditionally been used in the conditioning regimen for allogenetic hematopoietic stem cell transplantation (alloHCT) from an unrelated donor (u-HCT). However, patients are increasingly receiving a fludarabine-based conditioning regimen without TBI, as it seemed less toxic than TBI. We need to know the clinical results of non-TBI u-HCT treatments. We retrospectively investigated the clinical outcomes of allogenetic hematopoietic cell transplantation (alloHCT) from an unrelated donor without TBI (non-TBI u-HCT) and compared the clinical outcomes of fludarabine-based (FLU group) and cyclophosphamide-ATG (Cy-ATG group) conditioning regimens. Sixty-one patients received the non-TBI conditioning regimen for u-HCT (32 in the FLU group and 29 in the Cy-ATG group). The cumulative incidence of neutrophil engraftment at 30 days, platelet>20K/μL at 30 days, acute graft-versus host disease (aGvHD) at 100 days, and chronic GvHD (cGvHD) at 2 years were 87.01%, 65.57%, 35.20%, and 26.64%, respectively. However, transplantation outcomes and overall survival rates did not differ between the FLU and Cy-ATG groups. Only infused CD34+ cells >3×106kg-1 was identified as a favorable factor for survival in the multivariate analysis. In conclusion, non-TBI u-HCT was feasible and there was no difference between the FLU and Cy-ATG groups in terms of transplantation outcomes.

Original languageEnglish
Pages (from-to)730-736
Number of pages7
JournalLeukemia Research
Volume38
Issue number7
DOIs
Publication statusPublished - 2014 Jul

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Aplastic anemia
  • Fludarabine
  • Total body irradiation
  • Unrelated donor

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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  • Cite this

    Kim, H., Lee, K. H., Kim, I., Sohn, S. K., Jung, C. W., Joo, Y. D., Kim, S. H., Kim, B. S., Choi, J. H., Kwak, J. Y., Kim, M. K., Bae, S. H., Shin, H. J., Won, J. H., Lee, W. S., Oh, S., Kim, H. J., & Park, J. H. (2014). Allogeneic hematopoietic cell transplantation without total body irradiation from unrelated donor in adult patients with idiopathic aplastic anemia: Fludarabine versus cyclophosphamide-ATG. Leukemia Research, 38(7), 730-736. https://doi.org/10.1016/j.leukres.2014.01.002