Comparison of Conventional Cyclophosphamide versus Fludarabine-Based Conditioning in High-Risk Aplastic Anemia Patients Undergoing Matched-Related Donor Transplantation
- DOI
- 10.2991/chi.d.200426.001How to use a DOI?
- Keywords
- Aplastic anemia; Cyclophosphamide; Fludarabine; Stem cell transplantation
- Abstract
Allogeneic stem cell transplant for high-risk aplastic anemia (AA) yields inferior results using conventional cyclophosphamide (CY)-based conditioning. The use of fludarabine (Flu)-based regimens has resulted in improved outcomes in high-risk patients. Limited data are available comparing these two conditioning regimens in such patients. We retrospectively analyzed 192 high-risk patients undergoing matched-related donor transplantation from July 2001 to December 2018. The median age was 19.5 (2–52) years. Patients were divided into 2 groups, Cy200 anti-thymocyte globulin (ATG)20 (Gp1 n = 79) or Flu120–150 Cy120–160 ATG20 (Gp2 n = 113). The risk of graft failure was significantly higher in Gp1, and the majority occurred in patients with >2 risk factors (p = 0.02). The incidence of grade II-IV acute graft versus host disease (GVHD) and chronic GVHD was not significantly different between the two groups. The overall survival (OS) of the study cohort was 81.3 %, disease-free survival (DFS) 76.6 % and GVHD-free relapse-free survival (GRFS) was 64.1%. DFS and GRFS were significantly higher in Gp2 as compared to Gp1: DFS 84.1% versus 68.4 % (p = 0.02), GRFS 77.9% versus 54.4% (p = 0.01), respectively. We conclude that Flu-based conditioning is associated with superior OS, DFS and GRFS as compared to the conventional Cy-based regimen in high-risk AA.
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- © 2020 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
- Open Access
- This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
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TY - JOUR AU - Raheel Iftikhar AU - Qamar un Nisa Chaudhry AU - Tariq Mehmood Satti AU - Syed Kamran Mahmood AU - Tariq Ghafoor AU - Ghassan Umair Shamshad AU - Nighat Shahbaz AU - Mehreen Ali Khan AU - Tariq Azam Khattak AU - Jahanzeb Rehman AU - Muhammad Farhan AU - Saima Humayun AU - Humera Haq AU - Syeda Ammaara Anwaar Naqvi AU - Faiz Anwer AU - Humayoon Shafique Satti AU - Parvez Ahmed PY - 2020 DA - 2020/05/18 TI - Comparison of Conventional Cyclophosphamide versus Fludarabine-Based Conditioning in High-Risk Aplastic Anemia Patients Undergoing Matched-Related Donor Transplantation JO - Clinical Hematology International SP - 82 EP - 91 VL - 2 IS - 2 SN - 2590-0048 UR - https://doi.org/10.2991/chi.d.200426.001 DO - 10.2991/chi.d.200426.001 ID - Iftikhar2020 ER -