Unmanipulated Haploidentical Hematopoietic Stem Cell Transplantation Achieved Outcomes Comparable With Matched Unrelated Donor Transplantation in Young Acquired Severe Aplastic Anemia

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Yue LuDaopei Lu

Abstract

Salvage haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is considered in patients with severe aplastic anemia (SAA) if a matched unrelated donor (MUD) is unavailable. However, studies on haplo- and MUD transplantation in SAA are lacking. The present study retrospectively analyzed the outcomes of 89 young SAA patients who underwent unmanipulated alternative HSCT between September 2012 and September 2016 at our single center. Forty-one patients received haploidentical donors and forty-eight patients MUDs for HSCT. Most were heavily transfused and refractory to previous immunotherapy. The median durations for myeloid engraftment in the haplo- and MUD cohorts were 14 (range, 10 to 21) and 13 (range, 10 to 18) days, respectively. Compared with the MUD cohort, haplo-HSCT cohorts had an increased cumulative incidence of acute graft-versus-host disease (GVHD) grades II to IV (43.9% ± 7.8% versus 12.5% ± 4.8%, P = .001) and grades III to IV (21.1% ± 6.7% versus 6.6% ± 3.7%, P = .045) and similar limited chronic GVHD (47.7% ± 8.5% versus 38.5% ± 7.3%, P = .129) and extensive chronic GVHD (12.1% ± 6.8% versus 9.1% ± 4.3%, P = .198). The median follow-up time of the surviving patients was 26 months (range, 6 to 45). No ...Continue Reading

Citations

Oct 26, 2018·The New England Journal of Medicine·Neal S Young
Aug 5, 2020·International Journal of Hematology·Lei YeSeiji Kojima
Dec 17, 2020·Bone Marrow Transplantation·Zheng-Li Xu, Xiao-Jun Huang
May 10, 2021·Transplantation and Cellular Therapy·Kaitai YangUNKNOWN Bone Marrow Failure Working Group of Hunan Province
Aug 4, 2021·Transfusion clinique et biologique : journal de la Société française de transfusion sanguine·Y-Y NiuT Wang

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