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Combined use of Chinese medicine with allogeneic hematopoietic stem cell transplantation for severe aplastic anemia patients

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Abstract

Objective

To determine the effect of combined treatment with Chinese medicine (CM) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) on patients with severe aplastic anemia (SAA).

Methods

Eleven patients were treated with CM plus allo-HSCT. Nine patients received a conditioning regimen consisting of fludarabine (Flu), anti-thymocyte globulin (pig ALG), or anti-lymphocyte globulin (Rabbit ATG) and cyclophosphamide (CY), and two patients received pig ALG and CY. All patients were treated with Kidney (Shen)-reinforcing, blood-activating, and stasis-removing (KBS) herbal preparation beginning at 1 week before transplantation and ending at 8 weeks after transplantation. Chimerism status was assessed by analyzing short tandem repeat (STR) polymorphisms.

Results

All patients recovered hematopoietic function and none had graft failure. The median number of days required for the absolute neutrophil count (ANC) increased to >0.5×109/L was 15 days (12–22 days) and for spontaneous platelet recovery to >20×109/L without post-transplantation transfusion was 17 days (15–27 days). Nine patients were long-term survivors and achieved full donor chimerism. The overall cumulative incidence of acute graft versus host disease (GVHD) grades I–II and III–IV was 18.2% (2/11) and 9.1% (1/11), respectively. The overall accumulated incidence of chronic GVHD was 27.3% and all patients had limited chronic GVHD. At a median follow-up time of 32 months (range: 12–97 months), 9 patients were still alive. The estimated 5-year overall survival (OS) rate was 81.8%. The incidence of treatment-related mortality, 2-year post-transplantation, was 18.2%. Two patients died from GVHD after transplantation.

Conclusion

Treatment with the KBS formulation may reduce the rate of graft failure and treatment-related mortality and improve the rate of OS in SAA patients with allo-HSCT.

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Authors and Affiliations

  1. Hematology Department, The First Affiliated Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310006, China

    Bao-dong Ye  (叶宝东), Xiang Zhang  (张 翔), Ke-ding Shao  (邵科钉), Dan Chen  (陈 丹), Yu Zhang  (张 宇), Di-jiong Wu  (吴迪炯), Qing-hong Yu  (俞庆宏), Jian-ping Shen  (沈建平), Yi-ping Shen  (沈一平) & Yu-hong Zhou  (周郁鸿)

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  1. Bao-dong Ye  (叶宝东)
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  2. Xiang Zhang  (张 翔)
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  3. Ke-ding Shao  (邵科钉)
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  4. Dan Chen  (陈 丹)
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  5. Yu Zhang  (张 宇)
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  6. Di-jiong Wu  (吴迪炯)
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  7. Qing-hong Yu  (俞庆宏)
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  8. Jian-ping Shen  (沈建平)
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  9. Yi-ping Shen  (沈一平)
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  10. Yu-hong Zhou  (周郁鸿)
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Corresponding author

Correspondence to Bao-dong Ye  (叶宝东).

Additional information

Supported by State Administration of Traditional Chinese Medicine (No. JDZX2012178), 2011 Special Research Funds for the Traditional Chinese Medicine Industry (No. 201107001) and Zhejiang Provincial Traditional Chinese Medicine Administration Bureau Program (No. 2007CA025)

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Ye, Bd., Zhang, X., Shao, Kd. et al. Combined use of Chinese medicine with allogeneic hematopoietic stem cell transplantation for severe aplastic anemia patients. Chin. J. Integr. Med. 20, 903–909 (2014). https://doi.org/10.1007/s11655-014-2026-9

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  • DOI: https://doi.org/10.1007/s11655-014-2026-9

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