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

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 Jan 1

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Unrelated Donors
Whole-Body Irradiation
Cell Transplantation
Cyclophosphamide
Transplantation
Poisons
Hematopoietic Stem Cell Transplantation
Graft vs Host Disease
Neutrophils
Blood Platelets
Multivariate Analysis
Survival Rate
Survival
fludarabine
Idiopathic Aplastic anemia
Incidence
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Allogeneic hematopoietic cell transplantation without total body irradiation from unrelated donor in adult patients with idiopathic aplastic anemia : Fludarabine versus cyclophosphamide-ATG. / Kim, Hawk; Lee, Kyoo Hyung; Kim, Inho; Sohn, Sang Kyun; Jung, Chul Won; Joo, Young Don; Kim, Sung Hyun; Kim, Byung Soo; Choi, Jung Hye; Kwak, Jae Yong; Kim, Min Kyoung; Bae, Sung Hwa; Shin, Ho Jin; Won, Jong Ho; Lee, Won Sik; Oh, Sukjoong; Kim, Hyo Jung; Park, Jae Hoo.

In: Leukemia Research, Vol. 38, No. 7, 01.01.2014, p. 730-736.

Research output: Contribution to journalArticle

Kim, H, Lee, KH, Kim, I, Sohn, SK, Jung, CW, Joo, YD, Kim, SH, Kim, BS, Choi, JH, Kwak, JY, Kim, MK, Bae, SH, Shin, HJ, Won, JH, Lee, WS, Oh, S, Kim, HJ & Park, JH 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, vol. 38, no. 7, pp. 730-736. https://doi.org/10.1016/j.leukres.2014.01.002
Kim, Hawk ; Lee, Kyoo Hyung ; Kim, Inho ; Sohn, Sang Kyun ; Jung, Chul Won ; Joo, Young Don ; Kim, Sung Hyun ; Kim, Byung Soo ; Choi, Jung Hye ; Kwak, Jae Yong ; Kim, Min Kyoung ; Bae, Sung Hwa ; Shin, Ho Jin ; Won, Jong Ho ; Lee, Won Sik ; Oh, Sukjoong ; Kim, Hyo Jung ; Park, Jae Hoo. / Allogeneic hematopoietic cell transplantation without total body irradiation from unrelated donor in adult patients with idiopathic aplastic anemia : Fludarabine versus cyclophosphamide-ATG. In: Leukemia Research. 2014 ; Vol. 38, No. 7. pp. 730-736.
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AU - Sohn, Sang Kyun

AU - Jung, Chul Won

AU - Joo, Young Don

AU - Kim, Sung Hyun

AU - Kim, Byung Soo

AU - Choi, Jung Hye

AU - Kwak, Jae Yong

AU - Kim, Min Kyoung

AU - Bae, Sung Hwa

AU - Shin, Ho Jin

AU - Won, Jong Ho

AU - Lee, Won Sik

AU - Oh, Sukjoong

AU - Kim, Hyo Jung

AU - Park, Jae Hoo

PY - 2014/1/1

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N2 - 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.

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KW - Total body irradiation

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