|
|
Prepublished online as a Blood First Edition Paper on August 28, 2003; DOI 10.1182/blood-2003-06-2146.
Submitted June 30, 2003
Accepted August 20, 2003
Acute graft-versus-host disease in patients with Fanconi anemia or acquired aplastic anemia undergoing bone marrow transplantation from HLA identical sibling donors: risk factors and influence on outcome
Philippe Guardiola, Gerard Socie, Xiaxin Li, Patricia Ribaud, Agnes Devergie, Helene Esperou, Patrice Richard, Richard Traineau, Anne Janin, and Eliane Gluckman*
Hematologie - Greffe de Moelle, Hopital Saint Louis, Paris, France
Etablissement Francais du Sang - Saint Louis, Paris, France
Laboratoire de Pathologie ERM 02 20 INSERM, Universite Paris VII, Paris, France
* Corresponding author; email: eliane.gluckman{at}sls.ap-hop-paris.fr.
To assess whether FA patients might be at risk for acute graft-versus-host disease (AGvHD) despite using low-intensity conditionings, we retrospectively analyzed the incidence of AGvHD and its impact on outcome in 37 FA patients and 73 patients with acquired aplastic anemia transplanted at Saint Louis Hospital from HLA-genotypic identical siblings with similar conditionings (thoraco-abdominal irradiation plus cyclophosphamide 20 [FA] or 150 mg/kg [AAA]). Despite being younger, FA patients had an increased risk of grade II-IV AGvHD (RR, 2.00, p=.021), especially in younger patients (RR, 7.93, p=.014). The risks of requiring systemic corticosteroids to treat AGvHD and experiencing cortico-resistant AGvHD were significantly increased in FA patients. Although non-FA and FA patients had similar 10-year outcomes, acute and chronic GvHD had a biphasic effect on FA patient outcome with an additional cluster of lethal events starting by 5 years post-transplant. This late survival fall, restricted to FA patients, was closely related to head-and-neck carcinomas (15-year incidence: 53%). FA patients represent a group at risk regarding AGvHD when using irradiation-based conditionings. The impact of AGvHD on survival may not be limited to the early post-transplant period, and may be a major risk factor for head-and-neck carcinomas and late mortality in FA patients.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
B. Neven, S. Leroy, H. Decaluwe, F. Le Deist, C. Picard, D. Moshous, N. Mahlaoui, M. Debre, J.-L. Casanova, L. Dal Cortivo, et al.
Long-term outcome after hematopoietic stem cell transplantation of a single-center cohort of 90 patients with severe combined immunodeficiency
Blood,
April 23, 2009;
113(17):
4114 - 4124.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Janin, H. Murata, C. Leboeuf, J.-M. Cayuela, E. Gluckman, L. Legres, A. Desveaux, M. Varna, P. Ratajczak, J. Soulier, et al.
Donor-derived oral squamous cell carcinoma after allogeneic bone marrow transplantation
Blood,
February 19, 2009;
113(8):
1834 - 1840.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. W. Lensch and G. Q. Daley
Scientific and clinical opportunities for modeling blood disorders with embryonic stem cells
Blood,
April 1, 2006;
107(7):
2605 - 2612.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. C. Guinan
Aplastic Anemia: Management of Pediatric Patients
Hematology,
January 1, 2005;
2005(1):
104 - 109.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. S. Rosenberg, G. Socie, B. P. Alter, and E. Gluckman
Risk of head and neck squamous cell cancer and death in patients with Fanconi anemia who did and did not receive transplants
Blood,
January 1, 2005;
105(1):
67 - 73.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
