Predictors of outcomes in hematopoietic cell transplantation for Fanconi anemia Journal Article
| Authors: | Cancio, M.; Troullioud Lucas, A. G.; Bierings, M.; Klein, E.; de Witte, M. A.; Smiers, F. J.; Bresters, D.; Boelens, J. J.; Smetsers, S. E. |
| Article Title: | Predictors of outcomes in hematopoietic cell transplantation for Fanconi anemia |
| Abstract: | Allogeneic hematopoietic cell transplantation (HCT) remains the only cure for the hematologic manifestations of Fanconi anemia (FA). We performed retrospective predictor analyses for HCT outcomes in FA for pediatric and young adult patients transplanted between 2007 and 2020 across three large referral institutions. Eighty-nine patients, 70 with bone marrow failure +/− cytogenetic abnormalities, 19 with MDS/AML, were included. Five-year overall survival (OS) was 83.2% and event-free survival (EFS) was 74%. Age ≥19, HLA mismatch and year of HCT were multivariable predictors (MVPs) for OS, EFS and treatment-related mortality (TRM). In the pediatric group, TCD was a borderline MVP (P = 0.059) with 5-year OS of 73.0% in TCD vs. 100% for T-replete HCT. The cumulative incidence of day 100 grade II-IV aGvHD and 5-year cGvHD were 5.6% and 4.6%, respectively. Relapse in the MDS/AML subgroup occurred in 4 patients (16%). Graft failure was seen in 9 patients (TCD 6/37 [16%]; T-replete 3/52 [5.7%]). Six patients developed malignancy after HCT. Survival chances after HCT for FA are excellent and associated with high engrafted survival and low toxicity. Age ≥19, HLA mismatch, year of transplant and ‘TCD in the <19 years group’ (although borderline) were found to be negative predictors for survival. © 2023, The Author(s). |
| Keywords: | adolescent; adult; child; controlled study; event free survival; retrospective studies; young adult; major clinical study; overall survival; leukemia, myeloid, acute; busulfan; fludarabine; prednisone; mortality; methotrexate; cohort analysis; cytogenetics; cyclophosphamide; hematopoietic stem cell transplantation; retrospective study; prediction; thiotepa; age; acute graft versus host disease; chronic graft versus host disease; graft failure; hla matching; myelodysplastic syndrome; whole body radiation; graft versus host reaction; transplantation conditioning; outcomes research; multivariate analysis; tacrolimus; leukemia relapse; graft vs host disease; cyclosporine; patient referral; alemtuzumab; thymocyte antibody; fanconi anemia; cumulative incidence; bone marrow depression; complication; acute myeloid leukemia; mycophenolate mofetil; humans; human; male; female; article |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 59 |
| Issue: | 1 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2024-01-01 |
| Start Page: | 34 |
| End Page: | 40 |
| Language: | English |
| DOI: | 10.1038/s41409-023-02121-1 |
| PUBMED: | 37848556 |
| PROVIDER: | scopus |
| PMCID: | PMC10781622 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Maria Cancio -- Source: Scopus |
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