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Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study

BACKGROUND AND AIMS: How to select the treatment is a challenge for the management of acquired patients with infections. This study aimed at comparing the outcomes of SAA with infections who had an allogeneic hematopoietic stem cell transplantation (allo-HSCT)with that of patients who had an infecti...

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Autores principales: Liu, Limin, Miao, Miao, He, Hailong, Wang, Shunqing, Zhang, Yanming, Guo, Ailian, Jiao, Wenjing, Lei, Meiqing, Cai, Yifeng, Shangguan, Xiaohui, Liu, Zefa, Xu, Jinge, Li, Xiaoli, Zhang, Liansheng, Wu, Depei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483095/
https://www.ncbi.nlm.nih.gov/pubmed/36131940
http://dx.doi.org/10.3389/fimmu.2022.955095
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author Liu, Limin
Miao, Miao
He, Hailong
Wang, Shunqing
Zhang, Yanming
Guo, Ailian
Jiao, Wenjing
Lei, Meiqing
Cai, Yifeng
Shangguan, Xiaohui
Liu, Zefa
Xu, Jinge
Li, Xiaoli
Zhang, Liansheng
Wu, Depei
author_facet Liu, Limin
Miao, Miao
He, Hailong
Wang, Shunqing
Zhang, Yanming
Guo, Ailian
Jiao, Wenjing
Lei, Meiqing
Cai, Yifeng
Shangguan, Xiaohui
Liu, Zefa
Xu, Jinge
Li, Xiaoli
Zhang, Liansheng
Wu, Depei
author_sort Liu, Limin
collection PubMed
description BACKGROUND AND AIMS: How to select the treatment is a challenge for the management of acquired patients with infections. This study aimed at comparing the outcomes of SAA with infections who had an allogeneic hematopoietic stem cell transplantation (allo-HSCT)with that of patients who had an infection and received non-HSCT therapy. METHODS: We retrospectively compared the outcomes of patients with acquired SAA and infections who had an allo-HSCT (n = 141) with that of patients who had an infection and received non-HSCT therapy (n = 186) between July 2004 and January 2020. RESULTS: The treatment-related mortality (TRM) of grade 1-2 infections in the HSCT and non-HSCT groups was 24.99% and 13.68%, respectively (P = 0.206), while the TRM of grade 3-4 infections was lower in the HSCT group than that observed in the non-HSCT group (18.54% vs. 33.33%, P = 0.036). At 6 months post-treatment, 91.30% patients in the HSCT group and 8.78% patients in the non-HSCT group had achieved a normal blood profile (P < 0.0001). The time required to discontinue transfusions of red blood cells and platelets in the non-HSCT group was longer than in the HSCT group (P < 0.0001). Estimated overall survival (OS) at 6 years was similar in the two groups (75.5% ± 3.9% vs. 76.3% ± 3.1%, P = 0.996), while the estimated failure-free survival (FFS) at 6 years was 75.2% ± 3.8% in the HSCT group and 48.9% ± 3.7% in the non-HSCT group (P < 0.0001). Multivariate analysis showed that younger age, lower grade of infection (grade 1-2), and SAA (vs. very SAA) were favorable factors for OS (P < 0.05), and that the choice of HSCT and younger age were favorable factors for FFS (P < 0.0001). CONCLUSION: These results suggest that allo-HSCT has a better chance of a successful outcome than non-HSCT in SAA patients with an infection.
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spelling pubmed-94830952022-09-20 Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study Liu, Limin Miao, Miao He, Hailong Wang, Shunqing Zhang, Yanming Guo, Ailian Jiao, Wenjing Lei, Meiqing Cai, Yifeng Shangguan, Xiaohui Liu, Zefa Xu, Jinge Li, Xiaoli Zhang, Liansheng Wu, Depei Front Immunol Immunology BACKGROUND AND AIMS: How to select the treatment is a challenge for the management of acquired patients with infections. This study aimed at comparing the outcomes of SAA with infections who had an allogeneic hematopoietic stem cell transplantation (allo-HSCT)with that of patients who had an infection and received non-HSCT therapy. METHODS: We retrospectively compared the outcomes of patients with acquired SAA and infections who had an allo-HSCT (n = 141) with that of patients who had an infection and received non-HSCT therapy (n = 186) between July 2004 and January 2020. RESULTS: The treatment-related mortality (TRM) of grade 1-2 infections in the HSCT and non-HSCT groups was 24.99% and 13.68%, respectively (P = 0.206), while the TRM of grade 3-4 infections was lower in the HSCT group than that observed in the non-HSCT group (18.54% vs. 33.33%, P = 0.036). At 6 months post-treatment, 91.30% patients in the HSCT group and 8.78% patients in the non-HSCT group had achieved a normal blood profile (P < 0.0001). The time required to discontinue transfusions of red blood cells and platelets in the non-HSCT group was longer than in the HSCT group (P < 0.0001). Estimated overall survival (OS) at 6 years was similar in the two groups (75.5% ± 3.9% vs. 76.3% ± 3.1%, P = 0.996), while the estimated failure-free survival (FFS) at 6 years was 75.2% ± 3.8% in the HSCT group and 48.9% ± 3.7% in the non-HSCT group (P < 0.0001). Multivariate analysis showed that younger age, lower grade of infection (grade 1-2), and SAA (vs. very SAA) were favorable factors for OS (P < 0.05), and that the choice of HSCT and younger age were favorable factors for FFS (P < 0.0001). CONCLUSION: These results suggest that allo-HSCT has a better chance of a successful outcome than non-HSCT in SAA patients with an infection. Frontiers Media S.A. 2022-09-05 /pmc/articles/PMC9483095/ /pubmed/36131940 http://dx.doi.org/10.3389/fimmu.2022.955095 Text en Copyright © 2022 Liu, Miao, He, Wang, Zhang, Guo, Jiao, Lei, Cai, Shangguan, Liu, Xu, Li, Zhang and Wu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Liu, Limin
Miao, Miao
He, Hailong
Wang, Shunqing
Zhang, Yanming
Guo, Ailian
Jiao, Wenjing
Lei, Meiqing
Cai, Yifeng
Shangguan, Xiaohui
Liu, Zefa
Xu, Jinge
Li, Xiaoli
Zhang, Liansheng
Wu, Depei
Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study
title Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study
title_full Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study
title_fullStr Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study
title_full_unstemmed Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study
title_short Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study
title_sort severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: long-term outcomes of a multicenter study
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483095/
https://www.ncbi.nlm.nih.gov/pubmed/36131940
http://dx.doi.org/10.3389/fimmu.2022.955095
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