Efficacy and safety of allogeneic hematopoietic stem cell transplantation in the treatment of 28 patients with hepatitis-related aplastic anemia.
10.3760/cma.j.issn.0253-2727.2023.08.003
- Author:
Yan WANG
1
;
Jia LI
2
;
Ai Ming PANG
2
;
Dong Lin YANG
2
;
Xin CHEN
2
;
Rong Li ZHANG
2
;
Jia Lin WEI
2
;
Qiao Ling MA
2
;
Wei Hua ZHAI
2
;
Yi HE
2
;
Er Lie JIANG
2
;
Ming Zhe HAN
2
;
Si Zhou FENG
2
Author Information
1. State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China Yantai Yuhuangding Hospital, Yantai 264000, China.
2. State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China.
- Publication Type:Journal Article
- Keywords:
HLA-sibling allogeneic hematopoietic stem cell transplantation;
Haploidentical hematopoietic stem-cell transplantation.;
Hepatitis related aplastic anemia
- MeSH:
Male;
Female;
Humans;
Adult;
Treatment Outcome;
Anemia, Aplastic/therapy*;
Retrospective Studies;
Epstein-Barr Virus Infections;
Herpesvirus 4, Human;
Graft vs Host Disease/etiology*;
Hematopoietic Stem Cell Transplantation/adverse effects*;
Hepatitis/etiology*;
Bronchiolitis Obliterans Syndrome;
Transplantation Conditioning
- From:
Chinese Journal of Hematology
2023;44(8):628-634
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the efficacy and safety of HLA-haploidentical hematopoietic stem cell transplantation (allo-HSCT) for hepatitis-related aplastic anemia (HRAA) patients. Methods: Retrospective analysis was performed on hepatitis-associated aplastic anemia patients who received haplo-HSCT at our center between January 2012 and June 2022. October 30, 2022 was the final date of follow-up. Results: This study included 28 HRAA patients receiving allo-HSCT, including 18 males (64.3% ) and 10 females (35.7% ), with a median age of 25.5 (9-44) years. About 17 cases of severe aplastic anemia (SAA), 10 cases of very severe aplastic anemia (VSAA), and 1 case of transfusion-dependent aplastic anemia (TD-NSAA) were identified. Among 28 patients, 15 patients received haplo-HSCT, and 13 received MSD-HSCT. The 2-year overall survival (OS) rate, the 2-year failure-free survival (FFS) rate, the 2-year transplant-related mortality (TRM) rate, the 100-day grade Ⅱ-Ⅳ acute graft-versus-host disease (aGVHD) cumulative incidence rate, and the 2-year chronic graft-versus-host disease (cGVHD) cumulative incidence rate were 81.4%, 81.4% (95% CI 10.5% -20.6% ), 14.6% (95% CI 5.7% -34.3% ), 25.0% (95% CI 12.8% -45.4% ), and 4.2% (95% CI 0.6% -25.4% ), respectively. After transplantation, all patients had no significant liver function damage. Compared with the MSD-HSCT group, only the incidence of cytomegaloviremia was significantly higher in the haplo-HSCT group [60.0% (95% CI 35.2% -84.8% ) vs 7.7% (95% CI 0-22.2% ), P=0.004]. No statistically significant difference in the Epstein-Barr virus was found in the 2-year OS, 2-year FFS, 2-year TRM, and 100-day grade Ⅱ-Ⅳ aGVHD cumulative incidence rates and 2-year cGVHD cumulative incidence rate. Conclusion: Allo-HSCT is safe and effective for HRAA, and haplo-HSCT can be used as a safe and effective alternative for newly diagnosed HRAA patients who cannot obtain HLA-matched sibling donors.
