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Bone marrow transplantation for diamond-blackfan anemia. Biol Blood Marrow Transplant 2005 Aug;11(8):600-8

Date

07/26/2005

Pubmed ID

16041310

DOI

10.1016/j.bbmt.2005.05.005

Scopus ID

2-s2.0-22344441866   46 Citations

Abstract

Patients with Diamond-Blackfan anemia (DBA) who are unresponsive to or intolerant of corticosteroids, experience treatment failure with other treatments, develop additional cytopenias or clonal disease, or opt for curative therapy are often treated with allogeneic bone marrow transplantation. We studied the transplantation outcomes of 61 DBA patients whose data were reported to the International Bone Marrow Transplant Registry between 1984 and 2000. The median age was 7 years (range, 1-32 years). Among 55 patients with available transfusion information, 35 (64%) had received > or =20 units of blood before transplantation. Most patients (67%) received their bone marrow grafts from an HLA-matched related donor. The median time to neutrophil recovery was 17 days (range, 10-119 days) and to platelet recovery was 23 days (range, 9-119 days). Five patients did not achieve neutrophil engraftment. The 100-day mortality was 18% (95% confidence interval, 10%-29%). Grade II to IV acute graft-versus-host disease occurred in 28% (range, 17%-39%) and chronic graft-versus-host disease in 26% (range, 15%-39%). The 3-year probability of overall survival was 64% (range, 50%-74%). In univariate analysis, a Karnofsky score > or =90 and transplantation from an HLA-identical sibling donor were associated with better survival. These data suggest that allogeneic bone marrow transplantation is effective for the treatment of DBA. Transplantation before deterioration of the performance status and from an HLA-identical sibling donor may improve survival.

Author List

Roy V, PĂ©rez WS, Eapen M, Marsh JC, Pasquini M, Pasquini R, Mustafa MM, Bredeson CN, Non-Malignant Marrow Disorders Working Committee of the International Bone Marrow Transplant Registry

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Anemia, Diamond-Blackfan
Blood Component Transfusion
Bone Marrow Transplantation
Child
Child, Preschool
Female
Histocompatibility Testing
Humans
Infant
Karnofsky Performance Status
Male
Recovery of Function
Registries
Retrospective Studies
Tissue Donors
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a