Patient-, Disease-, and Transplant-Related Variables of Patients Receiving HLA-Identical Sibling Bone Marrow Transplantations for Severe Aplastic Anemia Between 1976 and 1992
| . | Year of Transplant . | P . | ||
|---|---|---|---|---|
| . | 1976-1980 . | 1981-1987 . | 1988-1992 . | . |
| N | 186 | 648 | 471 | |
| Etiology of SAA, no./no. evaluated (%) | .0001 | |||
| Idiopathic | 133/186 (72) | 512/646 (79) | 411/470 (87) | |
| Hepatitis | 24/186 (13) | 68/646 (11) | 26/470 (6) | |
| Toxin* | 25/186 (13) | 61/646 (9) | 30/470 (6) | |
| Other | 4/186 (2) | 5/646 (1) | 3/470 (1) | |
| Median age in yr (range) | 19 (2-56) | 20 (1-57) | 20 (1-51) | NS |
| Median no. of prior transfusions (range) | 25 (0-690) | 23 (0-598) | 25 (0-833) | NS |
| Granulocytes <0.2 × 109/L, no./no. evaluated (%) | 173/180 (96) | 479/627 (76) | 232/448 (52) | .0001 |
| Prior treatment, no./no. evaluated (%) | ||||
| None | 63/182 (35) | 266/630 (41) | 240/470 (51) | .0001 |
| Androgens | 80/178 (45) | 230/637 (36) | 115/470 (24) | .0001 |
| Steroids | 82/175 (47) | 272/639 (43) | 134/470 (29) | .0001 |
| ATG | 13/168 (8) | 86/633 (14) | 73/470 (16) | .04 |
| CSA | 0/71 (0) | 10/306 (3) | 32/434 (7) | .005 |
| Median time to transplant in mo (range) | 2 (0-118) | 2 (0-158) | 2 (0-232) | NS |
| Donor-recipient sex-match, no./no. evaluated (%) | NS | |||
| M-M | 64/179 (36) | 229/648 (36) | 162/470 (34) | |
| M-F | 27/179 (15) | 132/648 (20) | 104/470 (22) | |
| F-M | 53/179 (30) | 168/648 (26) | 121/470 (26) | |
| F-F | 35/179 (19) | 119/648 (18) | 83/470 (18) | |
| Alloimmunized† donor, no./no. evaluated (%) | 12/104 (12) | 71/539 (13) | 50/442 (11) | NS |
| Conditioning regimen, no./no. evaluated (%) | .0001 | |||
| Cy | 90/186 (48) | 299/648 (46) | 219/471 (46) | |
| Cy + TBI | 50/186 (27) | 80/648 (12) | 23/471 (5) | |
| Cy + LFR | 27/186 (15) | 249/648 (39) | 168/471 (36) | |
| Cy + ATG | 10/186 (5) | 12/648 (2) | 40/471 (9) | |
| Other | 9/186 (5) | 8/648 (1) | 21/471 (4) | |
| Median cell dose ×108/kg (range) | 3.1 (0.2-13) | 3.3 (0.3-13) | 3.3 (0.4-17) | NS |
| Isolation with LAF/HEPA, no./no. evaluated (%) | 79/176 (45) | 320/635 (50) | 352/453 (78) | .0001 |
| Donor buffy coat cells, no./no. evaluated (%) | 37/122 (30) | 162/639 (25) | 40/469 (9) | .0001 |
| GVHD prophylaxis, no./no. evaluated (%) | .0001 | |||
| MTX ± other | 155/186 (83) | 216/648 (33) | 7/470 (2) | |
| CSA ± other | 22/186 (12) | 297/648 (46) | 128/470 (27) | |
| MTX + CSA | 1/186 (0) | 99/648 (15) | 316/470 (67) | |
| T-cell depletion | 3/186 (2) | 25/648 (4) | 15/470 (3) | |
| Other | 5/186 (3) | 11/648 (2) | 4/470 (1) | |
| Other supportive care,‡ no./no. evaluated (%) | ||||
| Antibiotics | NA | 134/217 (62) | 352/471 (75) | .001 |
| Cotrimoxazole | NA | 77/217 (35) | 226/471 (48) | .002 |
| Intravenous immune globulin | NA | 177/217 (82) | 389/471 (83) | NS |
| Acyclovir | NA | 114/217 (53) | 379/471 (80) | .0001 |
| Growth factorsρ | NA | 0/217 (0) | 29/471 (6) | .0001 |
| . | Year of Transplant . | P . | ||
|---|---|---|---|---|
| . | 1976-1980 . | 1981-1987 . | 1988-1992 . | . |
| N | 186 | 648 | 471 | |
| Etiology of SAA, no./no. evaluated (%) | .0001 | |||
| Idiopathic | 133/186 (72) | 512/646 (79) | 411/470 (87) | |
| Hepatitis | 24/186 (13) | 68/646 (11) | 26/470 (6) | |
| Toxin* | 25/186 (13) | 61/646 (9) | 30/470 (6) | |
| Other | 4/186 (2) | 5/646 (1) | 3/470 (1) | |
| Median age in yr (range) | 19 (2-56) | 20 (1-57) | 20 (1-51) | NS |
| Median no. of prior transfusions (range) | 25 (0-690) | 23 (0-598) | 25 (0-833) | NS |
| Granulocytes <0.2 × 109/L, no./no. evaluated (%) | 173/180 (96) | 479/627 (76) | 232/448 (52) | .0001 |
| Prior treatment, no./no. evaluated (%) | ||||
| None | 63/182 (35) | 266/630 (41) | 240/470 (51) | .0001 |
| Androgens | 80/178 (45) | 230/637 (36) | 115/470 (24) | .0001 |
| Steroids | 82/175 (47) | 272/639 (43) | 134/470 (29) | .0001 |
| ATG | 13/168 (8) | 86/633 (14) | 73/470 (16) | .04 |
| CSA | 0/71 (0) | 10/306 (3) | 32/434 (7) | .005 |
| Median time to transplant in mo (range) | 2 (0-118) | 2 (0-158) | 2 (0-232) | NS |
| Donor-recipient sex-match, no./no. evaluated (%) | NS | |||
| M-M | 64/179 (36) | 229/648 (36) | 162/470 (34) | |
| M-F | 27/179 (15) | 132/648 (20) | 104/470 (22) | |
| F-M | 53/179 (30) | 168/648 (26) | 121/470 (26) | |
| F-F | 35/179 (19) | 119/648 (18) | 83/470 (18) | |
| Alloimmunized† donor, no./no. evaluated (%) | 12/104 (12) | 71/539 (13) | 50/442 (11) | NS |
| Conditioning regimen, no./no. evaluated (%) | .0001 | |||
| Cy | 90/186 (48) | 299/648 (46) | 219/471 (46) | |
| Cy + TBI | 50/186 (27) | 80/648 (12) | 23/471 (5) | |
| Cy + LFR | 27/186 (15) | 249/648 (39) | 168/471 (36) | |
| Cy + ATG | 10/186 (5) | 12/648 (2) | 40/471 (9) | |
| Other | 9/186 (5) | 8/648 (1) | 21/471 (4) | |
| Median cell dose ×108/kg (range) | 3.1 (0.2-13) | 3.3 (0.3-13) | 3.3 (0.4-17) | NS |
| Isolation with LAF/HEPA, no./no. evaluated (%) | 79/176 (45) | 320/635 (50) | 352/453 (78) | .0001 |
| Donor buffy coat cells, no./no. evaluated (%) | 37/122 (30) | 162/639 (25) | 40/469 (9) | .0001 |
| GVHD prophylaxis, no./no. evaluated (%) | .0001 | |||
| MTX ± other | 155/186 (83) | 216/648 (33) | 7/470 (2) | |
| CSA ± other | 22/186 (12) | 297/648 (46) | 128/470 (27) | |
| MTX + CSA | 1/186 (0) | 99/648 (15) | 316/470 (67) | |
| T-cell depletion | 3/186 (2) | 25/648 (4) | 15/470 (3) | |
| Other | 5/186 (3) | 11/648 (2) | 4/470 (1) | |
| Other supportive care,‡ no./no. evaluated (%) | ||||
| Antibiotics | NA | 134/217 (62) | 352/471 (75) | .001 |
| Cotrimoxazole | NA | 77/217 (35) | 226/471 (48) | .002 |
| Intravenous immune globulin | NA | 177/217 (82) | 389/471 (83) | NS |
| Acyclovir | NA | 114/217 (53) | 379/471 (80) | .0001 |
| Growth factorsρ | NA | 0/217 (0) | 29/471 (6) | .0001 |
Abbreviations: SAA, severe aplastic anemia; Cy, cyclophosphamide; TBI, total body irradiation; LFR, limited field radiation; NS, not significant; NA, not available.
Aplasia developing after exposure to drugs or other chemicals.
Alloimmunized is defined as prior exposure to alloantigens by pregnancy or transfusion.
Data recorded since 1986; prophylactic use only.
ρ Granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor administered within 1 week of transplantation.