***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A prospect i ve r and omized trial of therapy for severe aplastic anemia was design ed to compare early bone marrow transplantation with conventional treatments .  All patients with a sibling matched at the major histocompatibility region were transplanted . Transplantation was performed with 17 - 100 ( median 33 ) days of original diagnosis . Conventional treatments included transfusion support with or without and rogens .  Twenty-four of 36 patients intered on the transplant arm are alive after 4 - 20 ( median 9 ) mo with full marrow reconstitution . Only two are limited by chronic graft-versus-host disease . In contrast only 12 of 31 conventionally treated patients are alive . Six of these survivors have improved , five incompletely . The 19 nontransplant deaths have occurred within 1 - 11 ( median 3 ) mo of diagnosis . Compared to nontransplant regimens , early transplantation more effectively restores normal marrow function and decreases the acute mortality of severe marrow aplasia ( p = 0.006 ) . Pending longer follow-up , early marrow transplantation appears to be the most effective available treatment for severe aplastic anemia Patients with refractory severe aplastic anemia ( SAA ) who lack a matched sibling or unrelated donor need new therapeutic approaches . Hematopoietic SCT ( HSCT ) using mismatched or haploidentical related donors has been used in the past , but was associated with a significant risk of GVHD and mortality . Recently , the use of post-transplant cyclophosphamide ( Cy ) has been shown to be an effective strategy to prevent GVHD in recipients of haploidentical HSCT , but the majority of reports have focused on patients with hematology malignancies . We describe the outcome of 16 patients who underwent haploidentical transplantation using a reduced-intensity conditioning regimen with post-transplant Cy . Stem cell sources were BM ( N=13 ) or PBSCs ( N=3 ) . The rate of neutrophil engraftment was 94 % and of platelet engraftment was 75 % . Two patients had secondary graft failure and were successfully salvaged with another transplant . Three patients developed acute GVHD being grade s 2–4 in two . Five patients have died and the 1-year OS was 67.1 % ( 95 % confidence interval : 36.5–86.4 % ) . In our small series , the use of a reduced-intensity conditioning with post-transplant Cy in haploidentical BMT was associated with high rates of engraftment and low risk of GVHD in patients with relapsed/refractory SAA The effects of HLA-identical sibling donor ( ISD ) hematopoietic stem cell transplantation ( HSCT ) on adults with intermediate- or high-risk acute myeloid leukemia ( AML ) in the first complete remission ( CR1 ) are well established . Previous single-center studies have demonstrated similar survival after unmanipulated haploidentical donor ( HID ) vs ISD HSCT for hematologic malignancies . To test the hypothesis that haploidentical HSCT would be a valid option as postremission therapy for AML patients in CR1 lacking a matched donor , we design ed a disease-specific , prospect i ve , multicenter study . Between July 2010 and November 2013 , 450 patients were assigned to undergo HID ( 231 patients ) or ISD HSCT ( 219 patients ) according to donor availability . Among HID and ISD recipients , the 3-year disease-free survival rate was 74 % and 78 % ( P = .34 ) , respectively ; the overall survival rate was 79 % and 82 % ( P = .36 ) , respectively ; cumulative incidences of relapse were 15 % and 15 % ( P = .98 ) ; and those of the nonrelapse-mortality were 13 % and 8 % ( P = .13 ) , respectively . In conclusion , unmanipulated haploidentical HSCT achieves outcomes similar to those of ISD HSCT for AML patients in CR1 . Such transplantation was demonstrated to be a valid alternative as postremission treatment of intermediate- or high-risk AML patients in CR1 lacking an identical donor . This trial was registered at www.chictr.org as # ChiCTR-OCH-10000940 A plastic anemia is a rare life-threatening disease . However , since the introduction of immunosuppressive therapy and allogeneic stem cell transplantation , the outcome has improved considerably , and the 5-year survival is reported to be 70–80 % in selected patient cohorts . Yet , contemporary population -based data on incidence and survival are lacking . We performed a national retrospective study to determine the incidence , treatment , and survival of patients with aplastic anemia diagnosed in Sweden from 2000–2011 . Patients were included via the National Patient Registry , and diagnosed according to the Camitta criteria . In total , 257 confirmed cases were identified , with an overall incidence of 2.35 ( 95 % CI : 2.06–2.64 ) cases per million inhabitants per year . Median age was 60 years ( range : 2–92 ) , and median follow up was 76 ( 0–193 ) months . Primary treatments included immunosuppressive therapy ( 63 % ) , allogenic stem cell transplantation ( 10 % ) , or single-agent cyclosporine/no specific therapy ( 27 % ) . The 5-year survival was 90.7 % in patients aged 0–18 years , 90.5 % in patients aged 19–39 years , 70.7 % in patients aged 40–59 years , and 38.1 % in patients aged ≥60 years . Multivariate analysis showed that age ( both 40–59 and ≥60 age groups ) , very severe aplastic anemia and single-agent cyclosporine/no specific therapy were independent risk factors for inferior survival . In conclusion , younger aplastic anemia patients experience a very good long-term survival , while that of patients ≥60 years in particular remains poor . Apparently , the challenge today is to improve the management of older aplastic anemia patients , and prospect i ve studies to address this medical need are warranted Posttransplant relapse is still the major cause of treatment failure in high-risk acute leukemia . Attempts to manipulate alloreactive T cells to spare normal cells while killing leukemic cells have been unsuccessful . In HLA-haploidentical transplantation , we reported that donor-derived T regulatory cells ( Tregs ) , coinfused with conventional T cells ( Tcons ) , protected recipients against graft-versus-host disease ( GVHD ) . The present phase 2 study investigated whether Treg-Tcon adoptive immunotherapy prevents posttransplant leukemia relapse .  Forty-three adults with high-risk acute leukemia ( acute myeloid leukemia 33 ; acute lymphoblastic leukemia 10 ) were conditioned  with a total body irradiation-based regimen . Grafts included CD34(+ ) cells ( mean 9.7 × 10(6)/kg ) , Tregs ( mean 2.5 × 10(6)/kg ) , and Tcons ( mean 1.1 × 10(6)/kg ) . No posttransplant immunosuppression was given . Ninety-five percent of patients achieved full-donor type engraftment and 15 % developed ≥ grade 2 acute GVHD . The probability of disease-free survival was 0.56 at a median follow-up of 46 months . The very low cumulative incidence of relapse ( 0.05 ) was significantly better than in historical controls . These results demonstrate the immunosuppressive potential of Tregs can be used to suppress GVHD without loss of the benefits of graft-versus-leukemia ( GVL ) activity . Humanized murine models provided insights into the mechanisms underlying separation of GVL from GVHD , suggesting the GVL effect is due to largely unopposed Tcon alloantigen recognition in bone marrow Purpose : Although matched-sibling donor ( MSD ) hematopoietic stem-cell transplantation ( HSCT ) has an established role in the management of adults with acute lymphoblastic leukemia ( ALL ) in first complete remission ( CR1 ) , the effect of haploidentical donor ( HID ) HSCT as post-remission treatment for this portion of patients is not defined . Experimental Design : Transplantation outcomes from HIDs or MSDs were compared in a disease-specific , biologically phase III r and omized , multicenter study . Between July 2010 and December 2013 , 210 patients with Philadelphia-negative high-risk ALL in CR1 were assigned to undergo unmanipulated HIDs ( 121 patients ) or MSDs HSCT ( 89 patients ) according to donor availability on an intent-to-treat ( ITT ) basis . Results : Overall , 24 of the 210 patients had lost transplant eligibility . Therefore , 186 of 210 ( 88 % ) patients were finally transplanted from MSD ( n = 83 ) or HID ( n = 103 ) . Based on the ITT principle , the 3-year disease-free survival ( DFS ) did not differ between HID and MSD groups [ 61 % , 95 % confidence interval ( CI ) , 52%–70 % ; vs. 60 % , CI , 49%–71 % ; P = 0.91 ] from CR , neither did DFS differ between the two groups ( 68 % , CI , 58%–78 % ; vs. 64 % , CI , 52%–76 % ; P = 0.56 ) from time of the graft , with cumulative incidence of nonrelapse mortality of 13 % ( CI , 7%–19 % ) and 11 % ( CI , 4%–18 % ; P = 0.84 ) and relapse rates of 18 % ( CI , 10%–26 % ) and 24 % ( CI , 14%–34 % ; P = 0.30 ) , respectively . Conclusions : Haploidentical HSCT achieves outcomes similar to those of MSD-HSCT for Philadelphia-negative high-risk ALL patients in CR1 . Such transplantation could be a valid alternative as post-remission treatment for high-risk ALL patients in CR1 lacking an identical donor . Clin Cancer Res ; 22(14 ) ; 3467–76 . © 2016 AACR Haploidentical hematopoietic stem cell transplantation ( haplo-HSCT ) is associated with an increased risk of graft failure and severe graft-versus-host disease ( GVHD ) . Recent studies have shown that mesenchymal stromal cells ( MSCs ) display potent immunosuppressive effects and can support normal hematopoiesis . In a multi-center trial , we co-transplanted culture-exp and ed donor-derived bone marrow MSCs ( BM-MSCs ) into 35 children with severe aplastic anemia ( SAA ) undergoing haplo-HSCT .  All 35 patients ( 100 % ) achieved hematopoietic reconstitution and showed sustained full donor chimerism . The median time for myeloid engraftment was 14 days ( range 10–22 days ) , while that for platelet engraftment was 18 days ( range 9–36 days ) . The incidence of grade II – IV acute GVHD and chronic GVHD was 25.71 and 22.86 % , respectively . The overall survival rate was 85.71 % with a median of 22 months ( range 3.5–37 months ) . The combined transplantation of haploidentical HSCs and BM-MSCs into children with SAA without an HLA-identical sibling donor is relatively safe and may represent an effective new therapy to improve survival rates and reduce the risk of graft failure BACKGROUND Acquired aplastic anemia results from immune‐mediated destruction of bone marrow . Immunosuppressive therapies are effective , but reduced numbers of residual stem cells may limit their efficacy . In patients with aplastic anemia that was refractory to immunosuppression , eltrombopag , a synthetic thrombopoietin‐receptor agonist , led to clinical ly significant increases in blood counts in almost half the patients . We combined st and ard immunosuppressive therapy with eltrombopag in previously untreated patients with severe aplastic anemia . METHODS We enrolled 92 consecutive patients in a prospect i ve phase 1–2 study of immunosuppressive therapy plus eltrombopag .  The three consecutively enrolled cohorts differed with regard to the timing of initiation and the duration of the eltrombopag regimen ( cohort 1 received eltrombopag from day 14 to 6 months , cohort 2 from day 14 to 3 months , and cohort 3 from day 1 to 6 months ) . The cohorts were analyzed separately . The primary outcome was complete hematologic response at 6 months . Secondary end points included overall response , survival , relapse , and clonal evolution to myeloid cancer . RESULTS The rate of complete response at 6 months was 33 % in cohort 1 , 26 % in cohort 2 , and 58 % in cohort 3 . The overall response rates at 6 months were 80 % , 87 % , and 94 % , respectively . The complete and overall response rates in the combined cohorts were higher than in our historical cohort , in which the rate of complete response was 10 % and the overall response rate was 66 % . At a median follow‐up of 2 years , the survival rate was 97 % ; one 
    Output:
    
We have concluded that Haploidentical HSCT was associated with promising outcomes in terms of successful engraftment and reduced complications .