Analysis of Risk Factors for Mortality of Children with Severe Aplastic Anemia after Allogeneic Hematopoietic Stem Cell Transplantation.
10.19746/j.cnki.issn.1009-2137.2025.03.040
- Author:
Yan CHEN
1
;
Hao XIONG
2
;
Zhi CHEN
2
;
Na SONG
1
;
Li YANG
1
;
Fang TAO
2
;
Li YANG
1
;
Zhuo WANG
2
;
Yu DU
2
;
Ming SUN
1
Author Information
1. Laboratory of Pediatric Hematology, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, Hubei Province, China.
2. Department of Hematology, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, Hubei Province, China.
- Publication Type:Journal Article
- Keywords:
severe aplastic anemia;
allogeneic hematopoietic stem cell transplantation;
risk factor
- MeSH:
Humans;
Anemia, Aplastic/therapy*;
Hematopoietic Stem Cell Transplantation/adverse effects*;
Risk Factors;
Retrospective Studies;
Child;
Transplantation, Homologous;
Male;
Female;
Graft vs Host Disease;
Child, Preschool;
Proportional Hazards Models;
Adolescent;
Infant
- From:
Journal of Experimental Hematology
2025;33(3):886-891
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To analyze the factors associated with mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with severe aplastic anemia (SAA).
METHODS:The clinical data of 90 children with SAA who received allo-HSCT in the Department of Hematology, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from August 2016 to July 2023 were collected. The clinical features and causes of death were analyzed retrospectively. Cox proportional hazards model was used to screen the risk factors of death.
RESULTS:Only 9 children died with a median time of 6.3(2.6, 8.3) months among the 90 children with SAA after allo-HSCT. Among the 5 deaths due to infection, 3 were pulmonary infection, including 2 cases of cytomegalovirus pneumonia. One case developed septic shock due to gastrointestinal infection. One case experienced graft failure, which was complicated by bloodstream infection, and developed septic shock. Three cases died of transplantation-associated thrombotic microangiopathy (TA-TMA). One case died of gastrointestinal graft-versus-host disease (GVHD). The results of multivariate analysis showed that post-transplant +60 d PLT≤30×109/L (HR=7.478, 95%CI : 1.177-47.527, P =0.033), aGVHD Ⅲ-Ⅳ (HR=7.991, 95%CI : 1.086-58.810, P =0.041), and TA-TMA occurrence (HR=13.699, 95%CI : 2.146-87.457, P =0.006) were independent risk factors for post-transplant mortality.
CONCLUSION:Allo-HSCT is an effective therapy for SAA in children. Post-transplant +60 d PLT≤30×109/L, aGVHD Ⅲ-Ⅳ, and TA-TMA occurrence are independently associated with post-transplant mortality, which may be helpful for early detection of potential high-risk children and optimization of clinical diagnostic and treatment strategies.
