A retrospective comparison of cyclophosphamide plus antithymocyte globulin with cyclophosphamide plus busulfan as the conditioning regimen for severe aplastic anemia

A retrospective comparison of cyclophosphamide plus antithymocyte globulin with cyclophosphamide plus busulfan as the conditioning regimen for severe aplastic anemia

Autor Ommati, Larissa Veloso Mendes Autor UNIFESP Google Scholar
Rodrigues, Celso Arrais Autor UNIFESP Google Scholar
Silva, A.r. Autor UNIFESP Google Scholar
Silva, L.p. Autor UNIFESP Google Scholar
Chauffaille, Maria de Lourdes Lopes Ferrari Autor UNIFESP Google Scholar
Oliveira, José Salvador Rodrigues de Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Hospital Santa Marcelina Serviço de Hematologia e Hemoterapia
Resumo Allogeneic hematopoietic stem cell transplantation (AHSCT) is the treatment of choice for young patients with severe aplastic anemia (SAA). The association of antithymocyte globulin (ATG) and cyclophosphamide (CY) is the most frequently used conditioning regimen for this disease. We performed this retrospective study in order to compare the outcomes of HLA-matched sibling donor AHSCT in 41 patients with SAA receiving cyclophosphamide plus ATG (ATG-CY, N = 17) or cyclophosphamide plus busulfan (BU-CY, N = 24). The substitution of BU for ATG was motivated by the high cost of ATG. There were no differences in the clinical features between the two groups, including age, gender, cytomegalovirus status, ABO match, interval between diagnosis and transplant, and number of total nucleated cells infused. No differences were observed in the time to neutrophil and platelet engraftment, or in the risk of veno-occlusive disease and hemorrhage. However, there was a higher risk of mucositis in the BU-CY group (71 vs 24%, P = 0.004). There were no differences in the incidence of neutrophil and platelet engraftment, acute and chronic graft-versus-host disease, and transplant-related mortality. There was a higher incidence of late rejection in the ATG-CY group (41 vs 4%, P = 0.009). Although the ATG-CY group had a longer follow-up (101 months) than the BU-CY group (67 months, P = 0.04), overall survival was similar between the groups (69 vs 58%, respectively, P = 0.32). We conclude that the association BU-CY is a feasible option to the conventional ATG-CY regimen in this population.
Palavra-chave Aplastic anemia
Allogeneic stem cell transplantation
Conditioning regimen
ATG-CY
BU-CY
Idioma Inglês
Data de publicação 2009-03-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 42, n. 3, p. 244-250, 2009.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 244-250
Fonte http://dx.doi.org/10.1590/S0100-879X2009000300005
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000264200100005
SciELO S0100-879X2009000300005 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/4933

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