Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience
Yıl: 2021 Cilt: 38 Sayı: 3 Sayfa Aralığı: 195 - 203 Metin Dili: İngilizce DOI: 10.4274/tjh.galenos.2021.2021.0105 İndeks Tarihi: 25-05-2022
Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience
Öz: Objective: Although inhibition of the complement system at different
steps is a promising therapy modality in patients with paroxysmal
nocturnal hemoglobinuria (PNH), allogeneic hematopoietic stem cell
transplantation (HCT) is still the only curative therapy, especially for
patients with intractable hemolysis or bone marrow failure. The aim
of this study is to evaluate the outcomes of allogeneic HCT in PNH
patients with aplastic anemia (PNH-AA) or without.
Materials and Methods: Thirty-five PNH/PNH-AA patients who were
treated with allogeneic HCT in 10 transplantation centers in Turkey
were retrospectively analyzed.
Results: Sixteen (45.7%) and 19 (54.3%) patients were diagnosed
with classical PNH and PNH-AA, respectively. The median age of the
patients was 32 (18-51) years. The 2-year overall survival (OS) rate and
rate of graft-versus-host disease-free, failure-free survival (GFFS) was
81.2% and 78.1%, respectively. The 2-year OS in cases of classical PNH
and PNH-AA was 81.3% and 79.9%, respectively (p=0.87), and 2-year
GFFS in cases of PNH and PNH-AA was 79% and 76% (p=0.977),without statistical significance. The OS and GFFS rates also did not
differ between transplantations with matched sibling donors (MSDs)
and matched unrelated donors (MUDs).
Conclusion: Allogeneic HCT with MSDs or MUDs is a good option
for selected patients with classical PNH and PNH-AA. In particular,
patients with debilitating and refractory hemolysis and patients with
bone marrow failure might form an excellent group of candidates for
allogeneic HCT
Anahtar Kelime: Aplastik Aneminin Eşlik Ettiği ve Etmediği Paroksismal Noktürnal Hemoglobinüri Hastalarında Hematopoetik Kök Hücre Nakli Deneyimi: Çok Merkezli Türkiye Deneyimi
Öz: Amaç: Paroksismal noktürnal hemoglobunüri (PNH) hastalarının
tedavisinde kompleman sisteminin değişik basamaklardaki inhibisyonu
umut vadedici bir tedavi yöntemidir. Ancak hastalığın belirti ve
bulgularını kontrol etmekte etkin bir tedavi yöntemi olsa da küratif bir
tedavi seçeneği değildir. Özellikle kompleman inhibisyonuna rağmen
devam eden hemolizi, replasman ihtiyacı ve kemik iliği yetmezliği
ile birlikteliği olan hasta grubunda halen tek küratif tedavi seçeneği
allojeneik kök hücre naklidir (KHN). Bu çalışmamızda aplastik anemi
ile birlikteliği olan (PNH-AA) ve olmayan PNH hastalarında yapılmış
allojeneik KHN’nin sonuçlarını değerlendirmeyi amaçladık.
Gereç ve Yöntemler: On ayrı merkezde PNH/PNH-AA tanısı olup
allojeneik KHN yapılan toplam 35 hasta retrospektif olarak tarandı.
Bulgular: On altı (%45,7) PNH ve 19 (%54,3) PNH-AA hastası
çalışmaya dahil edildi. Hastaların ortanca yaşı 32 (18-51) idi.
Hastalardaki sağkalım analizlerine baktığımızda; 2 yıllık genel sağkalım
(GS) ve graft versus host hastalıksız ve graft yetmezliksiz sağkalım
(GFFS) oranları sırasıyla %81,2 ve %78,1 idi. İki yıllık sağkalım PNve PNH-AA hastalarında sırasıyla %81,3 ve %79,9 olarak hesaplandı
ve gruplar arasında istatistiksel bir fark tespit edilmedi (p=0,87). Tam
uyumlu akraba donör ve tam uyumlu akraba dışı donör alt grupları
karşılaştırıldığında 2 yıllık OS ve GFFS oranlarında istatistiksel fark
gözlenmedi.
Sonuç: Seçilmiş PNH ve PNH-AA hasta grubunda akraba veya akraba
dışı tam uyumlu donör ile yapılan allojeneik KHN uygun bir seçenektir.
Özellikle refrakter hemolizi ve replasman ihtiyacı devam eden ve
kemik iliği yetmezliği bulguları olan hasta grubunda allojeneik KHN
bir tedavi seçeneği olarak değerlendirilmelidir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA | YILMAZ F, SOYER N, Cengiz Seval G, BOZDAĞ S, TOPÇUOĞLU P, ÜNAL A, Kaynar L, Ozgur G, SUCAK G, GOKER A, Velet M, ÖZDOĞU H, YILMAZ M, KAYA E, SALİM O, deveci B, KARADOĞAN İ, SAYDAM G (2021). Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. , 195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
Chicago | YILMAZ Fergün,SOYER Nur,Cengiz Seval Guldane,BOZDAĞ Sinem CİVRİZ,TOPÇUOĞLU Pervin,ÜNAL Ali,Kaynar Leylagul,Ozgur Gokhan,SUCAK Gülsan,GOKER ALI HAKAN,Velet Mustafa,ÖZDOĞU Hakan,YILMAZ MEHMET,KAYA Emin,SALİM Ozan,deveci BURAK,KARADOĞAN İhsan,SAYDAM Güray Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. (2021): 195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
MLA | YILMAZ Fergün,SOYER Nur,Cengiz Seval Guldane,BOZDAĞ Sinem CİVRİZ,TOPÇUOĞLU Pervin,ÜNAL Ali,Kaynar Leylagul,Ozgur Gokhan,SUCAK Gülsan,GOKER ALI HAKAN,Velet Mustafa,ÖZDOĞU Hakan,YILMAZ MEHMET,KAYA Emin,SALİM Ozan,deveci BURAK,KARADOĞAN İhsan,SAYDAM Güray Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. , 2021, ss.195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
AMA | YILMAZ F,SOYER N,Cengiz Seval G,BOZDAĞ S,TOPÇUOĞLU P,ÜNAL A,Kaynar L,Ozgur G,SUCAK G,GOKER A,Velet M,ÖZDOĞU H,YILMAZ M,KAYA E,SALİM O,deveci B,KARADOĞAN İ,SAYDAM G Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. . 2021; 195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
Vancouver | YILMAZ F,SOYER N,Cengiz Seval G,BOZDAĞ S,TOPÇUOĞLU P,ÜNAL A,Kaynar L,Ozgur G,SUCAK G,GOKER A,Velet M,ÖZDOĞU H,YILMAZ M,KAYA E,SALİM O,deveci B,KARADOĞAN İ,SAYDAM G Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. . 2021; 195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
IEEE | YILMAZ F,SOYER N,Cengiz Seval G,BOZDAĞ S,TOPÇUOĞLU P,ÜNAL A,Kaynar L,Ozgur G,SUCAK G,GOKER A,Velet M,ÖZDOĞU H,YILMAZ M,KAYA E,SALİM O,deveci B,KARADOĞAN İ,SAYDAM G "Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience." , ss.195 - 203, 2021. 10.4274/tjh.galenos.2021.2021.0105 |
ISNAD | YILMAZ, Fergün vd. "Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience". (2021), 195-203. https://doi.org/10.4274/tjh.galenos.2021.2021.0105 |
APA | YILMAZ F, SOYER N, Cengiz Seval G, BOZDAĞ S, TOPÇUOĞLU P, ÜNAL A, Kaynar L, Ozgur G, SUCAK G, GOKER A, Velet M, ÖZDOĞU H, YILMAZ M, KAYA E, SALİM O, deveci B, KARADOĞAN İ, SAYDAM G (2021). Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. Turkish Journal of Hematology, 38(3), 195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
Chicago | YILMAZ Fergün,SOYER Nur,Cengiz Seval Guldane,BOZDAĞ Sinem CİVRİZ,TOPÇUOĞLU Pervin,ÜNAL Ali,Kaynar Leylagul,Ozgur Gokhan,SUCAK Gülsan,GOKER ALI HAKAN,Velet Mustafa,ÖZDOĞU Hakan,YILMAZ MEHMET,KAYA Emin,SALİM Ozan,deveci BURAK,KARADOĞAN İhsan,SAYDAM Güray Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. Turkish Journal of Hematology 38, no.3 (2021): 195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
MLA | YILMAZ Fergün,SOYER Nur,Cengiz Seval Guldane,BOZDAĞ Sinem CİVRİZ,TOPÇUOĞLU Pervin,ÜNAL Ali,Kaynar Leylagul,Ozgur Gokhan,SUCAK Gülsan,GOKER ALI HAKAN,Velet Mustafa,ÖZDOĞU Hakan,YILMAZ MEHMET,KAYA Emin,SALİM Ozan,deveci BURAK,KARADOĞAN İhsan,SAYDAM Güray Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. Turkish Journal of Hematology, vol.38, no.3, 2021, ss.195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
AMA | YILMAZ F,SOYER N,Cengiz Seval G,BOZDAĞ S,TOPÇUOĞLU P,ÜNAL A,Kaynar L,Ozgur G,SUCAK G,GOKER A,Velet M,ÖZDOĞU H,YILMAZ M,KAYA E,SALİM O,deveci B,KARADOĞAN İ,SAYDAM G Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. Turkish Journal of Hematology. 2021; 38(3): 195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
Vancouver | YILMAZ F,SOYER N,Cengiz Seval G,BOZDAĞ S,TOPÇUOĞLU P,ÜNAL A,Kaynar L,Ozgur G,SUCAK G,GOKER A,Velet M,ÖZDOĞU H,YILMAZ M,KAYA E,SALİM O,deveci B,KARADOĞAN İ,SAYDAM G Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience. Turkish Journal of Hematology. 2021; 38(3): 195 - 203. 10.4274/tjh.galenos.2021.2021.0105 |
IEEE | YILMAZ F,SOYER N,Cengiz Seval G,BOZDAĞ S,TOPÇUOĞLU P,ÜNAL A,Kaynar L,Ozgur G,SUCAK G,GOKER A,Velet M,ÖZDOĞU H,YILMAZ M,KAYA E,SALİM O,deveci B,KARADOĞAN İ,SAYDAM G "Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience." Turkish Journal of Hematology, 38, ss.195 - 203, 2021. 10.4274/tjh.galenos.2021.2021.0105 |
ISNAD | YILMAZ, Fergün vd. "Hematopoietic Stem Cell Transplantation for Patients with Paroxysmal Nocturnal Hemoglobinuria with or without Aplastic Anemia: A Multicenter Turkish Experience". Turkish Journal of Hematology 38/3 (2021), 195-203. https://doi.org/10.4274/tjh.galenos.2021.2021.0105 |