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Combined use of Chinese medicine with allogeneic hematopoietic stem cell transplantation for severe aplastic anemia patients / 中国结合医学杂志
Chinese journal of integrative medicine ; (12): 903-909, 2014.
Article in English | WPRIM | ID: wpr-310885
ABSTRACT
<p><b>OBJECTIVE</b>To determine the effect of combined treatment with Chinese medicine (CM) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) on patients with severe aplastic anemia (SAA).</p><p><b>METHODS</b>Eleven patients were treated with CM plus allo-HSCT. Nine patients received a conditioning regimen consisting of fludarabine (Flu), anti-thymocyte globulin (pig ALG), or anti-lymphocyte globulin (Rabbit ATG) and cyclophosphamide (CY), and two patients received pig ALG and CY. All patients were treated with Kidney (Shen)-reinforcing, blood-activating, and stasis-removing (KBS) herbal preparation beginning at 1 week before transplantation and ending at 8 weeks after transplantation. Chimerism status was assessed by analyzing short tandem repeat (STR) polymorphisms.</p><p><b>RESULTS</b>All patients recovered hematopoietic function and none had graft failure. The median number of days required for the absolute neutrophil count (ANC) increased to >0.5×10(9)/L was 15 days (12-22 days) and for spontaneous platelet recovery to >20×10(9)/L without post-transplantation transfusion was 17 days (15-27 days). Nine patients were long-term survivors and achieved full donor chimerism. The overall cumulative incidence of acute graft versus host disease (GVHD) grades I-II and III-IV was 18.2% (2/11) and 9.1% (1/11), respectively. The overall accumulated incidence of chronic GVHD was 27.3% and all patients had limited chronic GVHD. At a median follow-up time of 32 months (range 12-97 months), 9 patients were still alive. The estimated 5-year overall survival (OS) rate was 81.8%. The incidence of treatment-related mortality, 2-year post-transplantation, was 18.2%. Two patients died from GVHD after transplantation.</p><p><b>CONCLUSION</b>Treatment with the KBS formulation may reduce the rate of graft failure and treatment-related mortality and improve the rate of OS in SAA patients with allo-HSCT.</p>
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Syndrome / Therapeutics / Transplantation, Homologous / Drugs, Chinese Herbal / Treatment Outcome / Combined Modality Therapy / Hematopoietic Stem Cell Transplantation / Sus scrofa / Therapeutic Uses / Kaplan-Meier Estimate Limits: Animals / Female / Humans / Male Language: English Journal: Chinese journal of integrative medicine Year: 2014 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Syndrome / Therapeutics / Transplantation, Homologous / Drugs, Chinese Herbal / Treatment Outcome / Combined Modality Therapy / Hematopoietic Stem Cell Transplantation / Sus scrofa / Therapeutic Uses / Kaplan-Meier Estimate Limits: Animals / Female / Humans / Male Language: English Journal: Chinese journal of integrative medicine Year: 2014 Type: Article