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Blood, 1 April 2004, Vol. 103, No. 7, pp. 2490-2497. Prepublished online as a Blood First Edition Paper on December 4, 2003; DOI 10.1182/blood-2003-07-2546. This Article Full Text (PDF) All Versions of this Article: 2003-07-2546v1 103/7/2490    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ades, L. Articles by Socie, G. Search for Related Content PubMed PubMed Citation Articles by Ades, L. Articles by Socie, G. Social Bookmarking                   What's this? Submitted July 29, 2003 Accepted November 24, 2003 Long-term outcome after bone marrow transplantation for severe aplastic anemia Lionel Ades, Jean-Yves Mary, Marie Robin, Christele Ferry, Raphael Porcher, Helene Esperou, Patricia Ribaud, Agnes Devergie, Richard Traineau, Eliane Gluckman, and Gerard Socie* Service d'Hematologie-Greffe de Moelle, Hospital St Louis, Paris, France INSERM ERM-0321, Hospital St Louis, Paris, France INSERM ERM-0220, Hospital St Louis, Paris, France * Corresponding author; email: gsocie{at}chu-stlouis.fr. From January 1978 to December 2001, 133 patients with severe aplastic anemia underwent non-T-cell depleted allogeneic bone marrow transplantation from an HLA-identical sibling donor, at the hospital Saint Louis using either the association of cyclophosphamide (Cy) and of thoraco-abdominal irradiation (TAI) (n=100) or of Cy and anti-thymocyte globulin (ATG) (n=33), as conditioning regimen. With a 13.6 years follow-up, the 10-year survival estimates was 64%. Four factors were associated with lower survival: older age, use of Cy-TAI, any form of treatment prior transplant [either androgens or immunosuppressive therapy, (IST)] and grade II-IV acute GvHD. TAI was the sole factor associated with the occurrence of acute GvHD. The risk of cancers (20-year cumulative incidence; 10.9%) was associated with older age and with the use of cyclosporine as IST pre-transplant. Cumulative incidences and risk factors of non-malignant late effect including avascular osteonecrosis, late bacterial, viral and fungal infection were also analyzed. Improved results using Cy-ATG as conditioning can lead to more than 80% chance of cure in patients with SAA. However, only avoidance of any IST before transplant in patients with sibling donor are compatible with such excellent results. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. Maury, A. Bacigalupo, P. Anderlini, M. Aljurf, J. Marsh, G. Socie, R. Oneto, J. R. Passweg, and on behalf of the Severe Aplastic Anemia Working Pa Improved outcome of patients older than 30 years receiving HLA-identical sibling hematopoietic stem cell transplantation for severe acquired aplastic anemia using fludarabine-based conditioning: a comparison with conventional conditioning regimen Haematologica, September 1, 2009; 94(9): 1312 - 1315. [Abstract] [Full Text] [PDF] R. Gurion, A. Gafter-Gvili, M. Paul, L. Vidal, I. Ben-Bassat, M. Yeshurun, O. Shpilberg, and P. Raanani Hematopoietic growth factors in aplastic anemia patients treated with immunosuppressive therapy-systematic review and meta-analysis Haematologica, May 1, 2009; 94(5): 712 - 719. [Abstract] [Full Text] [PDF] J. D. Rizzo, R. E. Curtis, G. Socie, K. A. Sobocinski, E. Gilbert, O. Landgren, L. B. Travis, W. D. Travis, M. E. D. Flowers, D. L. Friedman, et al. Solid cancers after allogeneic hematopoietic cell transplantation Blood, January 29, 2009; 113(5): 1175 - 1183. 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Harris, S. A. Feig, M. C. Territo, R. H. Collins, P. A. McSweeney, E. A. Copelan, et al. Optimization of conditioning for marrow transplantation from unrelated donors for patients with aplastic anemia after failure of immunosuppressive therapy Blood, September 1, 2006; 108(5): 1485 - 1491. [Abstract] [Full Text] [PDF] J. Marsh Making Therapeutic Decisions in Adults with Aplastic Anemia Hematology, January 1, 2006; 2006(1): 78 - 85. [Abstract] [Full Text] [PDF] M. Fuhrer, U. Rampf, I. Baumann, A. Faldum, C. Niemeyer, G. Janka-Schaub, W. Friedrich, W. Ebell, A. Borkhardt, C. Bender-Goetze, et al. Immunosuppressive therapy for aplastic anemia in children: a more severe disease predicts better survival Blood, September 15, 2005; 106(6): 2102 - 2104. [Abstract] [Full Text] [PDF] A K Enjeti, M Seldon, and S Braye Bilateral breast lumps in a patient after sex mismatched allogeneic transplantation for aplastic anaemia J. Clin. Pathol., June 1, 2005; 58(6): 670 - 671. [Full Text] [PDF] J. P. 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