Outcome of Severe Aplastic Anemia Treated with Immunosuppressive Therapy Compared with Bone Marrow Transplantation

BACKGROUND: We compared response rates and survival after allogeneic bone marrow transplantation (BMT) or immunosuppressive treatment in severe aplastic anemia (SAA) and identified prognostic factors related with survival. METHODS: Medical data of SAA patients who treated with BMT or immunosuppressive therapy (IST) at the Ajou University Hospital from January 1995 to December 2005 were retrospectively analyzed. RESULTS: Total 43 patients were evaluable. 18 patients (41.9%) were treated with IST (antithymocyte globulin plus cyclosporine A plus steroid) and 25 patients (58.1%) were treated with allogeneic BMT. In the IST group, response rate was 77.8%(2 complete remission, 12 partial remission) and there were two treatment failures. As later complications, acute myeloid leukemia developed in 1 patient and myelodysplastic syndrome developed in 2 patients. In the BMT group, response rate was 92.0%(18 complete remission, 5 partial remission) (p<0.001). 6 patients developed grade II to III acute graft-versus-host-disease (GVHD) and 3 patients developed chronic GVHD. The median survival time in all patients was 60.27 months, the 5-year survival rate was 61.0% in the IST group and 81.9%(p=0.144) in the BMT group. The factors influencing overall survival were age under 40-year and positive treatment response. CONCLUSION: This study shows that allogeneic BMT resulted in good response rate and overall survival rate in patients with SAA compared to IST. But overall survival rate between the two groups is statistically insignificant. Our study suggest that the younger age SAA patients with HLA-matched BMT donors may benefit more from allogeneic BMT.

Author dc:creator

• 김, 형일

Contributors dc:contributor

• 김, 효철
• 대학원 의학과
• 104550

• Severe aplastic anemia
• Bone marrow transplantation
• Immunosuppressive therapy
• 중증재생불량성빈혈
• 복합면역억제요법

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000001867
000000001867

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1620