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Allogeneic Hematopoietic Cell Transplantation for the Treatment of Severe Aplastic Anemia: Evidence-Based Guidelines from the American Society for Transplantation and Cellular Therapy.
Iftikhar, Raheel; DeFilipp, Zachariah; DeZern, Amy E; Pulsipher, Michael A; Bejanyan, Nelli; Burroughs, Lauri M; Kharfan-Dabaja, Mohamed A; Arai, Sally; Kassim, Adetola; Nakamura, Ryotaro; Saldaña, Blachy J Dávila; Aljurf, Mahmoud; Hamadani, Mehdi; Carpenter, Paul A; Antin, Joseph H.
Afiliación
  • Iftikhar R; Armed Forces Bone Marrow Transplant Center, National University of Medical Sciences, Rawalpindi, Pakistan. Electronic address: raheeliftikhar@afbmtc-nibmt.org.pk.
  • DeFilipp Z; Hematopoietic Cell Transplant and Cell Therapy Program, Massachusetts General Hospital, Boston, Massachusetts.
  • DeZern AE; Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland.
  • Pulsipher MA; Division of Pediatric Hematology and Oncology, Intermountain Primary Children's Hospital, Huntsman Cancer Institute, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT.
  • Bejanyan N; Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida.
  • Burroughs LM; Fred Hutchinson Cancer Center, Clinical Research Division and University of Washington, Seattle, Washington.
  • Kharfan-Dabaja MA; Division of Hematology-Oncology, Blood and Marrow Transplantation and Cellular Therapy Program, Mayo Clinic, Jacksonville, FL.
  • Arai S; Division of BMT and Cell Therapy, Department of Medicine, Stanford University Medical Center, Stanford, California.
  • Kassim A; Division of Hematology/Oncology, The Vanderbilt Clinic, Nashville, TN.
  • Nakamura R; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA.
  • Saldaña BJD; Division of Blood and Marrow Transplantation, Children's National Hospital, Washington DC.
  • Aljurf M; Adult Hematology and Stem Cell Transplant, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Hamadani M; Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
  • Carpenter PA; Fred Hutchinson Cancer Center, Clinical Research Division and University of Washington, Seattle, Washington.
  • Antin JH; Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts.
Transplant Cell Ther ; 2024 Sep 20.
Article en En | MEDLINE | ID: mdl-39307421
ABSTRACT
Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative treatment for severe aplastic anemia (SAA). Existing guidance about HCT in SAA is primarily derived from expert reviews, registry data and societal guidelines; however, transplant-specific guidelines for SAA are lacking. A panel of SAA experts, both pediatric and adult transplant physicians, developed consensus recommendations using Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology employing a GRADE guideline development tool. The panel agrees with previous recommendations for the preferential use of bone marrow as a graft source and the use of rabbit over horse antithymocyte globulin (ATG) for HCT conditioning. Fludarabine containing regimens are preferred for patients at high risk of graft failure and those receiving matched unrelated or haploidentical donor transplant. Given advancements in HCT, the panel does not endorse the historical 40-year age cut-off for considering upfront HCT in adults, acknowledging that fit older patients may also benefit from HCT. The panel also endorses increased utilization of HCT by prioritizing matched unrelated or haploidentical donor HCT over immunosuppressive therapy in children and adults who lack a matched related donor. Finally, the panel suggests either calcineurin inhibitor plus methotrexate or post-transplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis for matched related or matched unrelated donor recipients. These recommendations reflect a significant advancement in transplant strategies for SAA and highlight the importance of ongoing and further research to revisit current evidence in terms of donor choice, conditioning chemotherapy, GVHD prophylaxis and post-transplant immunosuppression.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Transplant Cell Ther Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Transplant Cell Ther Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos