Table 3.
Alternative donor stem-cell transplantation for severe aplastic anemia
| Study | Year of publication | N | Donor source, N | Conditioning | Age, y, median (range) | Acute GVHD,*% | Chronic GVHD, % | Survival, % |
|---|---|---|---|---|---|---|---|---|
| Nagoya111 | 2001 | 15 | MUD: 11; MMUD: 4 | Cy/ATG/TBI | 11 (3-19) | 33 | 13 | 100 at 4 y |
| Great Britain112 | 2001 | 8 | MUD: 7; MMUD: 1 | Cy/CP/TBI | 7 (0-10) | 25 | 0 | 100 at 3 y |
| Japan Marrow | 2002 | 154 | MUD: 79; MMUD: 75 | Cy ± TBI or LFI; Cy/ATG ± TBI or LFI | 17 (1-46) | 29 | 30 | 56 at 5 y |
| Donor | ||||||||
| Program113 | ||||||||
| Memphis114 | 2004 | 9 | MUD: 4; MMUD: 5 | High CD34+ cell dose, TCD, Cy/ATG/TLI or TBI ± thiotepa | 11 (6-16) | 0 | 0 | 89 at 4 y |
| Gyeonggi-do115 | 2004 | 5 | MUD | Cy/Flu/ATG | 13 (7-18) | 0 | 0 | 80 at 2 y |
| Guangzhou116 | 2004 | 6 | UCB | Cy/ATG | 26 (22-37) | 0 | 33 | 66 at 2 y |
| Genoa117 | 2005 | 38 | MUD: 33; MMRD: 5 | Cy/Flu/ATG | 14 (3-37) | 11 | 24 | 73 at 2 y |
| Philadelphia118 | 2005 | 12 | MUD: 4; MMUD: 8 | Partial TCD, TBI + Cy/Ara-C or Cy/TT or ATG | 9 (1-20) | 33 | 25 | 75 at 4 y |
| Seoul119 | 2005 | 13 | MUD: 12; MMUD: 1 | Cy/ATG | 22 (15-34) | 31 | 62 | 75 at 3 y |
| IBMTR92 | 2006 | 318 | MUD: 181; MMRD: 86; MMUD: 51 | Various | 16 (1-55) | 48 for MUD | 29 for MUD | 39 at 5 y for MUD |
| Seattle120 | 2006 | 87 | MUD: 62; MMUD: 25 | Cy/ATG/TBI | 19 (1-53) | 70 for MUD | 52 for MUD | 61 at 5 y for MUD |
Only studies reporting at least 5 patients are tabulated. GVHD, graft-versus-host disease; IBMTR, International Blood and Marrow Transplant Registry; MUD, matched unrelated donor; MMUD, mismatched unrelated donor; Cy, cyclophosphamide; ATG, antithymocyte globulin; TBI, total body irradiation; CP, alemtuzumab; LFI, limited field irradiation; TCD, T-cell depletion; TLI, total lymphoid irradiation; Flu, fludarabine; UCB, umbilical cord blood; MMRD, mismatched related donor; and TT, thiotepa
*
GVHD results are generally for grades II to IV and patients at risk