Tacrolimus versus Cyclosporine after Hematopoietic Cell Transplantation for Acquired Aplastic Anemia

被引：13

作者：

Inamoto, Yoshihiro ^{[1
]}

Flowers, Mary E. D. ^{[2
]}

Wang, Tao ^{[3
,4
]}

Urbano-Ispizua, Alvaro ^{[5
,6
]}

Hemmer, Michael T. ^{[3
]}

Cutler, Corey S. ^{[7
]}

Couriel, Daniel R. ^{[8
]}

Alousi, Amin M. ^{[9
]}

Antin, Joseph H. ^{[7
]}

Gale, Robert Peter ^{[10
]}

Gupta, Vikas ^{[11
]}

Hamilton, Betty K. ^{[12
]}

Kharfan-Dabaja, Mohamed A. ^{[13
]}

Marks, David I. ^{[14
]}

Ringden, Olle T. H. ^{[15
,16
]}

Socie, Gerard ^{[17
]}

Solh, Melhem M. ^{[18
]}

Akpek, Goerguen ^{[19
]}

Cairo, Mitchell S. ^{[20
]}

Chao, Nelson J. ^{[21
]}

Hayashi, Robert J. ^{[22
]}

Nishihori, Taiga ^{[13
]}

Reshef, Ran ^{[23
]}

Saad, Ayman ^{[24
]}

Shah, Ami ^{[25
]}

Teshima, Takanori ^{[26
]}

Tallman, Martin S. ^{[27
]}

Wirk, Baldeep ^{[28
]}

Spellman, Stephen R. ^{[29
]}

Arora, Mukta ^{[30
]}

Martin, Paul J. ^{[2
]}

机构：

[1] Natl Canc Ctr, Div Hematopoiet Stem Cell Transplantat, Tokyo 1040045, Japan

[2] Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA

[3] Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA

[4] Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA

[5] Univ Barcelona, Dept Hematol, Hosp Clin, IDIBAPS, Barcelona, Spain

[6] Inst Res Josep Carreras, Barcelona, Spain

[7] Dana Farber Canc Inst, Dept Med Oncol, Ctr Hematol Oncol, Boston, MA 02115 USA

[8] Univ Michigan, Dept Med, Ann Arbor, MI 48109 USA

[9] Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Div Canc Med, Houston, TX 77030 USA

[10] Univ London Imperial Coll Sci Technol & Med, Hematol Res Ctr, Dept Med, Div Expt Med, London, England

[11] Univ Hlth Network, Princess Margaret Canc Ctr, Blood & Marrow Transplant Program, Toronto, ON, Canada

[12] Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA

[13] Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA

[14] Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England

[15] Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden

[16] Ctr Allogene Stem Cell Transplantat, Stockholm, Sweden

[17] Hosp St Louis, Dept Hematol, Paris, France

[18] Florida Hosp, Med Grp, Blood & Marrow Transplant Ctr, Orlando, FL USA

[19] Banner MD Anderson Canc Ctr, Stem Cell Transplantat & Cellular Therapy Program, Gilbert, AZ USA

[20] New York Med Coll, Dept Pediat, Valhalla, NY 10595 USA

[21] Duke Univ, Med Ctr, Dept Med, Div Cell Therapy & Hematol, Durham, NC 27710 USA

[22] Washington Univ, Dept Pediat, Sch Med St Louis, Div Pediat Hematol Oncol, St Louis, MO 63130 USA

[23] Univ Penn, Med Ctr, Abramson Canc Ctr, Dept Med, Philadelphia, PA 19104 USA

[24] Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA

[25] Univ Calif Los Angeles, Dept Pediat, Mattel Childrens Hosp, Div Hematol Oncol, Los Angeles, CA 90024 USA

[26] Hokkaido Univ, Grad Sch Med, Dept Hematol, Sapporo, Hokkaido, Japan

[27] Mem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, New York, NY 10021 USA

[28] Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA

[29] Ctr Int Blood & Marrow Transplant Res, Natl Marrow Donor Program, Be Match, Minneapolis, MN USA

[30] Univ Minnesota, Med Ctr, Dept Med, Div Hematol,Oncol,Transplantat, Minneapolis, MN 55455 USA

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2015年 / 21卷 / 10期

关键词：

Aplastic anemia; Hematopoietic cell transplantation; Graft-versus-host disease; Immunosuppression; Cyclosporine; Tacrolimus; BONE-MARROW-TRANSPLANTATION; VERSUS-HOST-DISEASE; UNRELATED DONOR TRANSPLANTATION; PERIPHERAL-BLOOD; COMPARING METHOTREXATE; SIBLING DONORS; ACUTE GVHD; PHASE-III; GRAFT; PROPHYLAXIS;

D O I：

10.1016/j.bbmt.2015.05.023

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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. (C) 2015 American Society for Blood and Marrow Transplantation.

引用

页码：1776 / 1782

页数：7

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