Effect of Stem Cell Source and Dose on Allogeneic Hematopoietic Stem Cell Transplantation in Adult Patients with Idiopathic Aplastic Anemia: Data from the Korean Aplastic Anemia Trials

Hawk Kim, Kyoo Hyung Lee, Sang Kyun Sohn, Inho Kim, Sung Hyun Kim, Yong Park, Jung Hye Choi, Jae Yong Kwak, Min Kyoung Kim, Sung Hwa Bae, Ho Jin Shin, Jong Ho Won, Won Sik Lee, Yunsuk Choi

Research output: Contribution to journalArticle

Abstract

Objective: We aimed to evaluate the effect of stem cell source and dose on the survival of various donor subgroups, such as matched sibling donor (MSDs) and alternative donors (ADs), upon bone marrow (BM) or peripheral blood stem cell (PBSC) infusion in aplastic anemia (AA). Methods: We retrospectively investigated the effects of stem cell source and dose on allogeneic hematopoietic stem cell transplantation (alloHSCT) in AA. Results: A total of 267 patients were included in this analysis. The BM-treated group showed an association with low incidence of any-grade acute graft versus host disease (GvHD) (p < 0.001). A higher stem cell dose was related with a low incidence of extensive chronic GvHD in MSDs (p = 0.025). Multivariate analysis for overall survival (OS) revealed that only age at alloHSCT <31 years (p = 0.010) and prior platelet transfusion <86 U (p = 0.046) in MSDs and higher stem cell dose (hazard ratio = 2.596, p = 0.045) in ADs were favorable prognostic factors. Conclusion: PBSCs could be preferred in AD because high stem cell dose may be easily achieved to improve the OS at the expense of acute GvHD. However, BM stem cells are preferred in MSDs.

Original languageEnglish
JournalActa Haematologica
DOIs
Publication statusPublished - 2019 Jan 1

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Aplastic Anemia
Hematopoietic Stem Cell Transplantation
Stem Cells
Tissue Donors
Siblings
Graft vs Host Disease
Survival
Bone Marrow
Platelet Transfusion
Idiopathic Aplastic anemia
Incidence
Bone Marrow Cells
Multivariate Analysis

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Idiopathic aplastic anemia
  • Korean aplastic anemia trials
  • Stem cell dose
  • Stem cell source

ASJC Scopus subject areas

  • Hematology

Cite this

Effect of Stem Cell Source and Dose on Allogeneic Hematopoietic Stem Cell Transplantation in Adult Patients with Idiopathic Aplastic Anemia : Data from the Korean Aplastic Anemia Trials. / Kim, Hawk; Lee, Kyoo Hyung; Sohn, Sang Kyun; Kim, Inho; Kim, Sung Hyun; Park, Yong; Choi, Jung Hye; Kwak, Jae Yong; Kim, Min Kyoung; Bae, Sung Hwa; Shin, Ho Jin; Won, Jong Ho; Lee, Won Sik; Choi, Yunsuk.

In: Acta Haematologica, 01.01.2019.

Research output: Contribution to journalArticle

Kim, Hawk ; Lee, Kyoo Hyung ; Sohn, Sang Kyun ; Kim, Inho ; Kim, Sung Hyun ; Park, Yong ; Choi, Jung Hye ; Kwak, Jae Yong ; Kim, Min Kyoung ; Bae, Sung Hwa ; Shin, Ho Jin ; Won, Jong Ho ; Lee, Won Sik ; Choi, Yunsuk. / Effect of Stem Cell Source and Dose on Allogeneic Hematopoietic Stem Cell Transplantation in Adult Patients with Idiopathic Aplastic Anemia : Data from the Korean Aplastic Anemia Trials. In: Acta Haematologica. 2019.
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abstract = "Objective: We aimed to evaluate the effect of stem cell source and dose on the survival of various donor subgroups, such as matched sibling donor (MSDs) and alternative donors (ADs), upon bone marrow (BM) or peripheral blood stem cell (PBSC) infusion in aplastic anemia (AA). Methods: We retrospectively investigated the effects of stem cell source and dose on allogeneic hematopoietic stem cell transplantation (alloHSCT) in AA. Results: A total of 267 patients were included in this analysis. The BM-treated group showed an association with low incidence of any-grade acute graft versus host disease (GvHD) (p < 0.001). A higher stem cell dose was related with a low incidence of extensive chronic GvHD in MSDs (p = 0.025). Multivariate analysis for overall survival (OS) revealed that only age at alloHSCT <31 years (p = 0.010) and prior platelet transfusion <86 U (p = 0.046) in MSDs and higher stem cell dose (hazard ratio = 2.596, p = 0.045) in ADs were favorable prognostic factors. Conclusion: PBSCs could be preferred in AD because high stem cell dose may be easily achieved to improve the OS at the expense of acute GvHD. However, BM stem cells are preferred in MSDs.",
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T2 - Data from the Korean Aplastic Anemia Trials

AU - Kim, Hawk

AU - Lee, Kyoo Hyung

AU - Sohn, Sang Kyun

AU - Kim, Inho

AU - Kim, Sung Hyun

AU - Park, Yong

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 - Choi, Yunsuk

PY - 2019/1/1

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AB - Objective: We aimed to evaluate the effect of stem cell source and dose on the survival of various donor subgroups, such as matched sibling donor (MSDs) and alternative donors (ADs), upon bone marrow (BM) or peripheral blood stem cell (PBSC) infusion in aplastic anemia (AA). Methods: We retrospectively investigated the effects of stem cell source and dose on allogeneic hematopoietic stem cell transplantation (alloHSCT) in AA. Results: A total of 267 patients were included in this analysis. The BM-treated group showed an association with low incidence of any-grade acute graft versus host disease (GvHD) (p < 0.001). A higher stem cell dose was related with a low incidence of extensive chronic GvHD in MSDs (p = 0.025). Multivariate analysis for overall survival (OS) revealed that only age at alloHSCT <31 years (p = 0.010) and prior platelet transfusion <86 U (p = 0.046) in MSDs and higher stem cell dose (hazard ratio = 2.596, p = 0.045) in ADs were favorable prognostic factors. Conclusion: PBSCs could be preferred in AD because high stem cell dose may be easily achieved to improve the OS at the expense of acute GvHD. However, BM stem cells are preferred in MSDs.

KW - Allogeneic hematopoietic stem cell transplantation

KW - Idiopathic aplastic anemia

KW - Korean aplastic anemia trials

KW - Stem cell dose

KW - Stem cell source

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