Outcome of allogeneic hematopoietic stem cell transplantation in adult patients with hepatitis-associated aplastic anemia

Abstract

Outcomes of allogeneic hematopoietic stem cell transplantation (HSCT) for hepatitis-associated aplastic anemia have not been fully evaluated. In the present study, the outcomes of 37 adult patients with hepatitis-associated aplastic anemia who underwent allogeneic HSCT were retrospectively analyzed using the registry database of Japan Society for Hematopoietic Cell Transplantation. The median age of the patients was 24 years (range, 16–61). The median period between diagnosis of hepatitis-associated aplastic anemia and HSCT was 6.0 months (range, 0.5–430.8). Stem cell sources were bone marrow (N = 19) or peripheral blood stem cells (N = 5) from an HLA-identical sibling or bone marrow (N = 11) and cord blood (N = 2) from an unrelated donor. The majority of conditioning regimens were fludarabine-based or high-dose cyclophosphamide-based. In all but 2 cases of early death, neutrophil engraftment was achieved. At the time of analysis, 32 patients were alive, with a median follow-up of 54.1 months. Five-year overall and failure-free survival rates were 86.0% (95% CI, 69.4–93.9%) and 75.0% (95% CI, 57.4–86.2%), respectively. Despite the heterogeneity in transplant procedures in a small number of patients, these results suggest that allogeneic HSCT is safe for use in hepatitis-associated aplastic anemia with a low rate of transplant-related mortality.

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Acknowledgements

The authors would like to thank all the physicians and data managers of each transplant center and the staff member of Japanese Data Center for Hematopoietic Cell Transplantation.

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Correspondence to Takehiko Mori.

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Mineo Kurokawa receives consulting fees from Sanofi.k.k.

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Mori, T., Onishi, Y., Ozawa, Y. et al. Outcome of allogeneic hematopoietic stem cell transplantation in adult patients with hepatitis-associated aplastic anemia. Int J Hematol 109, 711–717 (2019). https://doi.org/10.1007/s12185-019-02644-8

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Keywords

  • Hepatitis-associated aplastic anemia
  • Allogeneic hematopoietic stem cell transplantation
  • Conditioning
  • Engraftment
  • Transplant-related mortality