PDF(Pubmed)
Abstract：
Immunosuppressive therapy for acquired severe aplastic anemia improves pancytopenia but has a significant risk of relapse (40%) and clonal evolution to myeloid neoplasms (15%), especially in patients older than 40. Yet, current guidelines for newly diagnosed severe aplastic anemia patients over the age of 40 recommend immunosuppressive therapy instead of curative allogeneic stem cell transplantation. Upfront allogeneic stem cell transplants are restricted to the rare patient who is not only young but also has a matched sibling donor. This article will discuss practice-changing data on the recent advances in upfront alternative donor hematopoietic cell transplants that could rewrite current treatment algorithms.
摘要：
获得性重型再生障碍性贫血的免疫抑制治疗可改善全血细胞减少症，但有明显的复发风险（40％）和克隆进化为髓系肿瘤（15％），尤其是40岁以上的患者。然而，目前针对40岁以上新诊断的重型再生障碍性贫血患者的指南推荐免疫抑制治疗，而不是治愈性异基因干细胞移植。前期的同种异体干细胞移植仅限于罕见的患者，他们不仅年轻，而且有匹配的同胞供体。本文将讨论有关可以重写当前治疗算法的前期替代供体造血细胞移植的最新进展的实践变化数据。
