PMID- 24104412
OWN - NLM
STAT- MEDLINE
DCOM- 20140403
LR  - 20220129
IS  - 1531-7048 (Electronic)
IS  - 1065-6251 (Linking)
VI  - 20
IP  - 6
DP  - 2013 Nov
TI  - Haematopoietic stem cell transplantation for acquired aplastic anaemia.
PG  - 515-20
LID - 10.1097/MOH.0b013e328365af83 [doi]
AB  - PURPOSE OF REVIEW: Survival outcomes from haematopoietic stem cell 
      transplantation (HSCT) in severe aplastic anaemia (SAA) have improved steadily 
      over the past decades, largely reflecting progress in supportive care and 
      conditioning regimens. Here we review recently published data that highlight the 
      improvements and current issues. RECENT FINDINGS: Human leukocyte antigen 
      (HLA)-matched sibling donor (MSD) HSCT remains the gold standard for SAA patients 
      younger than 40-50 years, with HLA-matched unrelated donor (MUD) HSCT for second 
      line after failure to respond to immunosuppressive therapy (IST). The use of 
      alternative donor sources for aplastic anaemia patients remains limited and 
      problematic, but novel conditioning regimens, particularly in the haploidentical 
      setting, justify further evaluation. In recent studies when comparing 
      alemtuzumab-based conditioning with standard antithymocyte globulin conditioning 
      regimens, lower rates of acute and chronic graft-versus-host disease and better 
      tolerance in older patients are seen. SUMMARY: Improving outcomes may lead to an 
      expanded frontline HSCT role in the future. In children lacking a MSD, 
      increasingly MUD HSCT is being considered as first-line treatment and is also 
      being considered more for young adults. Further research is needed to advance our 
      understanding of the role HSCT has to play in SAA with particular emphasis on 
      alternative donor sources and identifying optimal conditioning regimens.
FAU - Young, Moya E
AU  - Young ME
AD  - aHaematology Department, Kings College Hospital bKings College London, London, 
      UK.
FAU - Potter, Victoria
AU  - Potter V
FAU - Kulasekararaj, Austin G
AU  - Kulasekararaj AG
FAU - Mufti, Ghulam J
AU  - Mufti GJ
FAU - Marsh, Judith C
AU  - Marsh JC
LA  - eng
GR  - MR/J006742/1/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Hematol
JT  - Current opinion in hematology
JID - 9430802
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Age Factors
MH  - Anemia, Aplastic/*therapy
MH  - Antineoplastic Agents/therapeutic use
MH  - Donor Selection
MH  - Graft Rejection/prevention & control
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - Humans
MH  - Transplantation Conditioning/methods
MH  - Transplantation Tolerance
EDAT- 2013/10/10 06:00
MHDA- 2014/04/04 06:00
CRDT- 2013/10/10 06:00
PHST- 2013/10/10 06:00 [entrez]
PHST- 2013/10/10 06:00 [pubmed]
PHST- 2014/04/04 06:00 [medline]
AID - 00062752-201311000-00006 [pii]
AID - 10.1097/MOH.0b013e328365af83 [doi]
PST - ppublish
SO  - Curr Opin Hematol. 2013 Nov;20(6):515-20. doi: 10.1097/MOH.0b013e328365af83.