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Revista médica de Chile

Print version ISSN 0034-9887

Abstract

LEON, Pilar et al. Acquired aplastic anemia. Experience in a public hospital. Rev. méd. Chile [online]. 2018, vol.146, n.2, pp.175-182. ISSN 0034-9887.  http://dx.doi.org/10.4067/s0034-98872018000200175.

Background:

The first line treatment for patients < 40 years old with aplastic anemia (AA) is allogeneic HLA-identical sibling donor transplantation (SCT). Immunosuppressive therapy (IST) with a combination of Thymoglobuline (ATG) and cyclosporine is used for older patients or those without a donor. Five year overall survival (OS) for both therapies is > 70%.

Aim:

To report the experience with SCT and ATG for AA in a public hospital.

Patients and Methods:

AA was diagnosed in 42 patients between 1998 and 2016, according to Camitta criteria. Thirty eight (90%) received treatment, 7 (18%) under 40 years old received SCT, and 31 (82%) IST. The rest were not treated. OS was calculated from date of diagnosis until last control, death or loss from follow up.

Results:

Complete or partial hematologic response, was obtained in 71% and 58% of cases with SCT and IS, respectively. Five year OS was 71% and 55% with SCT and IST, respectively. No difference in response was observed between horse and rabbit ATG.

Conclusions:

SCT from an HLA-identical sibling donor had a high response rate and survival. IST instead, had a lower response and survival, due to an initial high mortality rate.

Keywords : Anemia; Aplastic; Homologous; Immunosuppression; Stem Cell Transplantation; Transplantation.

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