Allogeneic peripheral stem cell transplantation in patients with severe aplastic anemia: Single center experience
Journal Title: Ege Tıp Dergisi - Year 2017, Vol 56, Issue 2
Abstract
Aim: We retrospectively analyzed the clinical features, transplantation results and survival of patients with severe aplastic anemia (SAA) treated with allogeneic stem cell transplantations (ASCT) in adult transplantation unit. Materials and Methods: Eleven patients (6 male, 5 female) treated with 12 ASCTs were analyzed. All patients except 2 were treated with immunosuppressive treatment before ASCT. Peripheral CD34+ stem cells from HLA matched sibling donors (MSD) were transfused after conditioning regimens including cyclophosphamide, busulphan, antithymocyte globulin and fludarabine. Results: The median age at ASCT and time from diagnosis to ASCT were 22 years (17-38) and 9 months (3-108), respectively. The median 5.49 x 106/kg (4.9-12.7 x 106/kg) CD34+cells were transfused. The median duration of time to neutrophil and platelet engraftments were 21.5 (10-37) and 15 (14-29) days, respectively. Acute graft versus host disease (GVHD) and limited chronic GVHD were observed in 4 (36.3%) patients and 1 (9%) patient, respectively. Graft failure was seen in 2 (18.1%) of 11 patients. The median follow-up period was 33.5 months (0.5-59). Four (36.3%) of 11 patients died due to infection (3 patients) and liver failure (1 patient). Approximately 64% of all recipients are alive. The 5-year overall and event-free survival rates were 66.7% and 58.3%, respectively. Conclusion: Although we have few patients, our findings are seems to support that ASCT from a MSD remains the first choice for SAA patients younger than 40 years. Presence of MSD, shorter time from diagnosis to ASCT, using optimal conditioning regimens and choosing optimal stem cell source are seems to increase the success and survival rates of transplantation.
Authors and Affiliations
Nur Soyer, Ayşe Uysal, Oruç Murat Tombuloğlu, Filiz Vural
Gonadotropin ile oluşturulan kontrollü ovaryan stimulasyon-intrauterin inseminasyon sikluslarında kullanılan progesteron formunun ve tedavi etkinliğinin karşılaştırılması
Amaç: Gonadotropin ile ovulasyon induksiyonu yapılmış olan olgularda lüteal faz desteği için kullanılan progesteron formlarının gebelik başarısı açısından farklılık olup olmadığını karşılaştırmaktır. Gereç ve Yöntem: Bu...
Anti-TNF therapy-induced autoimmunity
Aim: Anti-TNF therapy has recently emerged as an effective therapy for treating rheumatic diseases. With this increasing use and longer follow-up periods of treatment, various adverse effects are emerging. These adverse...
Küçük hücreli dışı akciğer karsinomlarında tümör ilişkili makrofajların tümör progresyonundaki rolü
Amaç: Akciğer kanseri tüm dünyada kanserden ölümlerin en sık sebebidir. Küçük hücreli dışı akciğer karsinomları (KHDAK) da en sık görülen akciğer kanser tipidir. Bu çalışmada küçük hücreli dışı akciğer karsinomlarında, t...
Üriner sistem enfeksiyonlarından izole edilen Escherichia coli ve Klebsiella pneumoniae suşlarında florokinolon direncini etkileyen risk faktörlerinin değerlendirilmesi
Amaç: Antimikrobiyal direnç oranlarındaki artış, üriner sistem enfeksiyonlarında oral ampirik tedavi seçeneklerini kısıtlamaktadır. Dirençle ilgili risk faktörlerini belirlemek, ampirik antibiyotik seçimine yol göstermes...
Example of an infectious complication in injection drug users: Psoas abscess
In this case report, the authors aim to present a psoas abscess of an injection drug user. These patients mostly admit to emergency department (ED) because of infections with unknown origin. Because of the obscure sympto...