Second Allogeneic Hematopoietic Cell Transplantation for Patients with Fanconi Anemia and Bone Marrow Failure

Mouhab Ayas, Mary Eapen, Jennifer Le-Rademacher, Jeanette Carreras, Hisham Abdel-Azim, Blanche P. Alter, Paolo Anderlini, Minoo Battiwalla, Marc Bierings, David K. Buchbinder, Carmem Bonfim, Bruce M. Camitta, Anders L. Fasth, Robert Peter Gale, Michelle A. Lee, Troy C. Lund, Kasiani C. Myers, Richard F. Olsson, Kristin M. Page, Tim D. Prestidge & 6 others Mohamed Radhi, Ami J. Shah, Kirk R. Schultz, Baldeep Wirk, John E. Wagner, H. Joachim Deeg

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A second allogeneic hematopoietic cell transplantation (HCT) is the sole salvage option for individuals who develop graft failure after their first HCT. Data on outcomes after second HCT in patients with Fanconi anemia (FA) are scarce. Here we report outcomes after second allogeneic HCT for FA (n = 81). The indication for second HCT was graft failure after the first HCT. Transplantations were performed between 1990 and 2012. The timing of the second HCT predicted subsequent graft failure and survival. Graft failure was high when the second HCT was performed less than 3 months from the first. The 3-month probability of graft failure was 69% when the interval between the first HCT and second HCT was less than 3 months, compared with 23% when the interval was longer (P < .001). Consequently, the 1-year survival rate was substantially lower when the interval between the first and second HCTs was less than 3 months compared with longer (23% vs 58%; P = .001). The corresponding 5-year probability of survival was 16% and 45%, respectively (P = .006). Taken together, these data suggest that fewer than one-half of patients with FA undergoing a second HCT for graft failure are long-term survivors. There is an urgent need to develop strategies to reduce the rate of graft failure after first HCT.

Original languageEnglish (US)
Pages (from-to)1790-1795
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number10
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

Fingerprint

Fanconi Anemia
Cell Transplantation
Bone Marrow
Transplants
Graft Survival
Survivors

Keywords

  • Fanconi anemia
  • Graft failure
  • Second transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Ayas, M., Eapen, M., Le-Rademacher, J., Carreras, J., Abdel-Azim, H., Alter, B. P., ... Deeg, H. J. (2015). Second Allogeneic Hematopoietic Cell Transplantation for Patients with Fanconi Anemia and Bone Marrow Failure. Biology of Blood and Marrow Transplantation, 21(10), 1790-1795. https://doi.org/10.1016/j.bbmt.2015.06.012

Second Allogeneic Hematopoietic Cell Transplantation for Patients with Fanconi Anemia and Bone Marrow Failure. / Ayas, Mouhab; Eapen, Mary; Le-Rademacher, Jennifer; Carreras, Jeanette; Abdel-Azim, Hisham; Alter, Blanche P.; Anderlini, Paolo; Battiwalla, Minoo; Bierings, Marc; Buchbinder, David K.; Bonfim, Carmem; Camitta, Bruce M.; Fasth, Anders L.; Gale, Robert Peter; Lee, Michelle A.; Lund, Troy C.; Myers, Kasiani C.; Olsson, Richard F.; Page, Kristin M.; Prestidge, Tim D.; Radhi, Mohamed; Shah, Ami J.; Schultz, Kirk R.; Wirk, Baldeep; Wagner, John E.; Deeg, H. Joachim.

In: Biology of Blood and Marrow Transplantation, Vol. 21, No. 10, 01.10.2015, p. 1790-1795.

Research output: Contribution to journalArticle

Ayas, M, Eapen, M, Le-Rademacher, J, Carreras, J, Abdel-Azim, H, Alter, BP, Anderlini, P, Battiwalla, M, Bierings, M, Buchbinder, DK, Bonfim, C, Camitta, BM, Fasth, AL, Gale, RP, Lee, MA, Lund, TC, Myers, KC, Olsson, RF, Page, KM, Prestidge, TD, Radhi, M, Shah, AJ, Schultz, KR, Wirk, B, Wagner, JE & Deeg, HJ 2015, 'Second Allogeneic Hematopoietic Cell Transplantation for Patients with Fanconi Anemia and Bone Marrow Failure', Biology of Blood and Marrow Transplantation, vol. 21, no. 10, pp. 1790-1795. https://doi.org/10.1016/j.bbmt.2015.06.012
Ayas, Mouhab ; Eapen, Mary ; Le-Rademacher, Jennifer ; Carreras, Jeanette ; Abdel-Azim, Hisham ; Alter, Blanche P. ; Anderlini, Paolo ; Battiwalla, Minoo ; Bierings, Marc ; Buchbinder, David K. ; Bonfim, Carmem ; Camitta, Bruce M. ; Fasth, Anders L. ; Gale, Robert Peter ; Lee, Michelle A. ; Lund, Troy C. ; Myers, Kasiani C. ; Olsson, Richard F. ; Page, Kristin M. ; Prestidge, Tim D. ; Radhi, Mohamed ; Shah, Ami J. ; Schultz, Kirk R. ; Wirk, Baldeep ; Wagner, John E. ; Deeg, H. Joachim. / Second Allogeneic Hematopoietic Cell Transplantation for Patients with Fanconi Anemia and Bone Marrow Failure. In: Biology of Blood and Marrow Transplantation. 2015 ; Vol. 21, No. 10. pp. 1790-1795.
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AU - Ayas, Mouhab

AU - Eapen, Mary

AU - Le-Rademacher, Jennifer

AU - Carreras, Jeanette

AU - Abdel-Azim, Hisham

AU - Alter, Blanche P.

AU - Anderlini, Paolo

AU - Battiwalla, Minoo

AU - Bierings, Marc

AU - Buchbinder, David K.

AU - Bonfim, Carmem

AU - Camitta, Bruce M.

AU - Fasth, Anders L.

AU - Gale, Robert Peter

AU - Lee, Michelle A.

AU - Lund, Troy C.

AU - Myers, Kasiani C.

AU - Olsson, Richard F.

AU - Page, Kristin M.

AU - Prestidge, Tim D.

AU - Radhi, Mohamed

AU - Shah, Ami J.

AU - Schultz, Kirk R.

AU - Wirk, Baldeep

AU - Wagner, John E.

AU - Deeg, H. Joachim

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N2 - A second allogeneic hematopoietic cell transplantation (HCT) is the sole salvage option for individuals who develop graft failure after their first HCT. Data on outcomes after second HCT in patients with Fanconi anemia (FA) are scarce. Here we report outcomes after second allogeneic HCT for FA (n = 81). The indication for second HCT was graft failure after the first HCT. Transplantations were performed between 1990 and 2012. The timing of the second HCT predicted subsequent graft failure and survival. Graft failure was high when the second HCT was performed less than 3 months from the first. The 3-month probability of graft failure was 69% when the interval between the first HCT and second HCT was less than 3 months, compared with 23% when the interval was longer (P < .001). Consequently, the 1-year survival rate was substantially lower when the interval between the first and second HCTs was less than 3 months compared with longer (23% vs 58%; P = .001). The corresponding 5-year probability of survival was 16% and 45%, respectively (P = .006). Taken together, these data suggest that fewer than one-half of patients with FA undergoing a second HCT for graft failure are long-term survivors. There is an urgent need to develop strategies to reduce the rate of graft failure after first HCT.

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