Comparison ofhaploidentical donor versus HLA-matched sibling donor hematopoietic stem cell transplantation for severe aplastic anemia
10.3760/cma.j.cn421203-20201107-00381
- VernacularTitle:单倍体相同供者和HLA相合同胞供者HSCT治疗SAA的疗效和安全性比较
- Author:
Jiaying WU
1
;
Wenfang LUO
;
Yi XIAO
;
Yang CAO
;
Lifang HUANG
;
Na WANG
;
Jinhuan XU
;
Jue WANG
;
Fankai MENG
;
Donghua ZHANG
;
Yicheng ZHANG
Author Information
1. 华中科技大学同济医学院附属同济医院血液内科，武汉 430030
- Keywords:
Hematopoietic stem cell transplantation;
Severe aplastic anemia;
Haploidentical donor
- From:
Chinese Journal of Organ Transplantation
2021;42(12):738-743
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical outcomes and safety of haploidentical donor (HID)and HLA-matched sibling donor(MSD)hematopoietic stem cell transplantation(HSCT)for severe aplastic anemia(SAA).Methods:From January 1, 2012 to December 31, 2019, retrospective review of clinical data was performed for 75 SAA patients undergoing HSCT at Department of Hematology, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.Based upon donor sources, they were divided into two groups of MSD(49 cases)and HID (26 cases). And two groups were compared with regards to hematopoietic recovery, graft-versus-host disease(GVHD)infection and overall survival(OS).Results:Time of platelet and neutrophil engraftment of two groups was comparable(11 d vs.11 d, P=0.84; 11 d vs.12 d, P=0.08). Compared with HID group, MSD group had a lower incidence of acute GVHD(46.2% vs.18.4%, P=0.01)with a comparable incidence of grade Ⅱ-Ⅳ acute GVHD(26.9% vs.14.3%, P=0.24), grade Ⅲ-Ⅳ acute GVHD(15.4% vs.4.1%, P=0.09)and chronic GVHD(23.9% vs.23.1 %, P=0.71). A reactivation of CMV occurred in 27(55.1%)MSD and 22(84.6%)HID recipients( P=0.01). And the incidence of EB viremia was 69.4% and 61.5% respectively.After a median follow-up period of 54.0 and 18.5 months, the estimated 3-year OS rate of MSD and HID groups were 94.0% and 88.0% respectively ( P=0.35). Conclusions:HID HSCT is an effective and relatively safe option for SAA patients, especially for those in urgent need of treatment without MSD or refractory/relapse to immunosuppressive therapy.
