Tacrolimus versus cyclosporine after hematopoietic cell transplantation for acquired aplastic anemia Journal Article
| Authors: | Inamoto, Y.; Flowers, M. E. D.; Wang, T.; Urbano-Ispizua, A.; Hemmer, M. T.; Cutler, C. S.; Couriel, D. R.; Alousi, A. M.; Antin, J. H.; Gale, R. P.; Gupta, V.; Hamilton, B. K.; Kharfan-Dabaja, M. A.; Marks, D. I.; Ringdén, O. T. H.; Socié, G.; Solh, M. M.; Akpek, G.; Cairo, M. S.; Chao, N. J.; Hayashi, R. J.; Nishihori, T.; Reshef, R.; Saad, A.; Shah, A.; Teshima, T.; Tallman, M. S.; Wirk, B.; Spellman, S. R.; Arora, M.; Martin, P. J. |
| Article Title: | Tacrolimus versus cyclosporine after hematopoietic cell transplantation for acquired aplastic anemia |
| Abstract: | Combinations of cyclosporine (CSP) with methotrexate (MTX) have been widely used for immunosuppression after allogeneic transplantation for acquired aplastic anemia. We compared outcomes with tacrolimus (TAC)+MTX versus CSP+MTX after transplantation from HLA-identical siblings (SIB) or unrelated donors (URD) in a retrospective cohort of 949 patients with severe aplastic anemia. Study endpoints included hematopoietic recovery, graft failure, acute graft-versus-host disease (GVHD), chronic GVHD, and mortality. TAC+MTX was used more frequently in older patients and, in recent years, in both SIB and URD groups. In multivariate analysis, TAC+MTX was associated with a lower risk of mortality in URD recipients and with slightly earlier absolute neutrophil count recovery in SIB recipients. Other outcomes did not differ statistically between the 2 regimens. No firm conclusions were reached regarding the relative merits of TAC+MTX versus CSP+MTX after hematopoietic cell transplantation for acquired aplastic anemia. Prospective studies would be needed to determine whether the use of TAC+MTX is associated with lower risk of mortality in URD recipients with acquired aplastic anemia. © 2015 American Society for Blood and Marrow Transplantation. |
| Keywords: | adolescent; adult; child; controlled study; treatment outcome; aged; major clinical study; busulfan; fludarabine; mortality; methotrexate; neutrophil count; cohort analysis; hematopoietic stem cell transplantation; retrospective study; acute graft versus host disease; chronic graft versus host disease; graft failure; whole body radiation; graft survival; senescence; sibling; immunosuppressive treatment; tacrolimus; convalescence; cyclosporin; cyclosporine; graft recipient; alemtuzumab; thymocyte antibody; aplastic anemia; immunosuppression; hematopoietic cell transplantation; comparative effectiveness; graft-versus-host disease; unrelated donors; low risk patient; human; male; female; article; cyclophosphamide derivative |
| Journal Title: | Biology of Blood and Marrow Transplantation |
| Volume: | 21 |
| Issue: | 10 |
| ISSN: | 1083-8791 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2015-10-01 |
| Start Page: | 1776 |
| End Page: | 1782 |
| Language: | English |
| DOI: | 10.1016/j.bbmt.2015.05.023 |
| PROVIDER: | scopus |
| PMCID: | PMC4568149 |
| PUBMED: | 26033280 |
| DOI/URL: | |
| Notes: | Export Date: 2 October 2015 -- Source: Scopus |
