Abstract
This is a comparison of 218 patients with severe aplastic anemia (SAA) treated by allogeneic bone marrow transplantation (BMT) from HLA-identical sibling donors and 291 patients with SAA treated with immunosuppressive therapy (IS) with antilymphocyte globulin (ALG). The overall actuarial survival was 63% after BMT and 61% after IS therapy at 6 years. Younger patients (under 20) had a significantly better survival with BMT (66%) compared to IS (56%) (p = 0.01). The opposite was true for patients over the age of 20 (59%, 72%) (p = 0.0008). Transplantation was more effective in patients with less than 0.2×109/liter neutrophils (64 vs 41%) and the opposite was true for patients with more than 0.2×109/liter neutrophils. Infected patients had a better chance of surviving if transplanted (65 vs 45%). The same was true for patients with hemorrhages at the time of treatment (55 vs 40%). The results of ALG were superior to BMT for patients not infected (68 vs 60%) or with no hemorrhages at the time of treatment (77 vs 69%). A Cox regression analysis showed that the only significant pretreatment variables were a low neutrophil count (p = 0.001) and increasing age (p = 0.05).
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Bacigalupo, A. et al. (1990). Treatment of Severe Aplastic Anemia (SAA) with Bone Marrow Transplantation (BMT) or Immunosuppression: A Report of the EBMT SAA Working Party. In: Shahidi, N.T. (eds) Aplastic Anemia and Other Bone Marrow Failure Syndromes. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3254-4_10
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DOI: https://doi.org/10.1007/978-1-4612-3254-4_10
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