Abstract
We evaluated a novel alemtuzumab-based conditioning regimen in HSCT for acquired severe aplastic anemia (SAA). In a multicenter retrospective study, 50 patients received transplants from matched sibling donors (MSD; n = 21) and unrelated donors (UD; n = 29), using fludarabine 30 mg/m(2) for 4 days, cyclophosphamide 300 mg/m(2) for 4 days, and alemtuzumab median total dose of 60 mg (range: 40-100 mg). Median age was 35 years (range 8-62). Overall survival at 2 years was 95% +/- 5% for MSD and 83% for UD HSCT (p 0.34). Cumulative incidence of graft failure was 9.5% for MSD and 14.5% for UD HSCT. Full-donor chimerism (FDC) in unfractionated peripheral blood was 42%; no patient achieved CD3 FDC. Acute GVHD was observed in only 13.5% patients (all grade I-II) and only 2 patients (4%) developed chronic GVHD. A low incidence of viral infections was seen. Factors influencing overall survival were HSCT comorbidity 2-year index (92% with score 0-1 vs 42% with score >= 2, P <.001) and age (92% for age <50 years vs 71% >= 50 years, P <.001). Our data suggest that the use of an alemtuzumab-based HSCT regimen for SAA results in durable engraftment with a low incidence of chronic GVHD.
Original language | English |
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Pages (from-to) | 2351 - 2357 |
Number of pages | 7 |
Journal | Blood |
Volume | 118 |
Issue number | 8 |
DOIs | |
Publication status | Published - 25 Aug 2011 |