PMID: 9005744Jan 15, 1997Paper

Primary treatment of acquired aplastic anemia: outcomes with bone marrow transplantation and immunosuppressive therapy. Seattle Bone Marrow Transplant Team

Annals of Internal Medicine
K DoneyF R Appelbaum

Abstract

Both immunosuppressive therapy and bone marrow transplantation are accepted treatments for patients with aplastic anemia. Choosing one of these therapies for a given patient depends not only on donor availability but also on such factors as patient age. To compare survival rates and long-term complications after bone marrow transplantation or immunosuppressive therapy in patients with acquired aplastic anemia and to identify prognostic factors associated with improved survival. Center-based, retrospective analysis. Referral center for patients with aplastic anemia. 395 patients with acquired aplastic anemia. Bone marrow transplant from an HLA-identical, related donor or immunosuppressive therapy. Kaplan-Meier survival curves, results of log rank tests, and cumulative incidence curves. Of 168 bone marrow transplant recipients, 89% had sustained engraftment. Forty-six patients developed grade II to IV acute graft-versus-host disease, and 68 developed chronic graft-versus-host disease that required therapy. Of 227 patients who received immunosuppressive therapy, 44% achieved a complete, partial, or minimal response. Fifty-four percent died or had no response to therapy. Actuarial survival at 15 years was 69% for bone marrow transp...Continue Reading

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