The Effect of Serum Cytokine Levels prior Transplantation on the Outcome of Severe Aplastic Anemia Patients Received Allogeneic Hematopoietic Stem Cell Transplantation.

Zhao WANG; Yuan-Yuan SHI; Xin YANG; Su-Dong ZHANG; Li-Ning ZHANG; Dong-Lin YANG; Yi HE; Rong-Li ZHANG; Er-Lie JIANG; Jia-Lin WEI; Si-Zhou FENG; Min-Zhe HAN

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The Effect of Serum Cytokine Levels prior Transplantation on the Outcome of Severe Aplastic Anemia Patients Received Allogeneic Hematopoietic Stem Cell Transplantation.

VernacularTitle:移植前血清细胞因子水平对重型再生障碍性贫血患者异基因造血干细胞移植疗效的影响研究
Author: Zhao WANG ¹ ; Yuan-Yuan SHI ¹ ; Xin YANG ¹ ; Su-Dong ZHANG ¹ ; Li-Ning ZHANG ¹ ; Dong-Lin YANG ¹ ; Yi HE ¹ ; Rong-Li ZHANG ¹ ; Er-Lie JIANG ¹ ; Jia-Lin WEI ¹ ; Si-Zhou FENG ² ; Min-Zhe HAN ¹
Author Information

1. Institute of Hematology and Blood Diseases Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Tianjin 300020, China.
2. Institute of Hematology and Blood Diseases Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Tianjin 300020, China. E-mail: szfeng@ihcams.ac.cn.
Publication Type:Journal Article
MeSH: Anemia, Aplastic; Cytokines; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Retrospective Studies; Treatment Outcome
From: Journal of Experimental Hematology 2018;26(2):502-507
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo identify the role of serum cytokine levels prior allogeneic hematopoietic stem cell trans-plantation (allo-HSCT) in the outcome of severe aplastic anemia (SAA) patients received allo-HSCT treatment.
METHODSThe clinical data of 117 SAA patients received allo-HSCT were enrolled in this study. The overall survival (OS), graft versus host disease (GVHD) incidence and relationship of serum cytokines with OS and major transplantation complications were retrospectively analyzed.
RESULTSThe patients enrolled in this study included 78(66.7%) cases received HSCT matched sibling donors (MSD), 12(10.2%) HSCT of unrelated donors (MUD) and 27 cases received HSCT of haploidentical donors (HID). The 5-years OS was 76.0%(95% CI: 64.4-87.5%); aGVHD cumulative incidence was 49.6%(95% CI: 40.4%-58.8%) and cumulative incidence cGVHD was 31.6%(95% CI:23.1%-40.2%). MSD allo-HSCT had a significantly higher 5-years OS as compared with the other donors(82.3%±6.6% vs 61.3%±11.7%, P<0.05). HLA matching, donor's age, cytomegalovirus/ Epstein-Barr virus (CMV/EBV) infection were important factors of affecting occurence of aGVHD. The patients with higher serum IL-6 had reduced platelet recovery time after transplantation (14.6±1.8 vs 18.3±2.6 d)(P=0.050) and higher serum TNF-α level accompanied by a lower incidence of CMV/EBV infection (37.8%±11.1% vs 58.8±16.8%)(P<0.05).
CONCLUSIONMSD allo-HSCT is the effective treatment for SAA patients. Donor's type remains the strong predictor of survival. The serum levels IL-6 and TNF-α before transplantation associate with platelet recovery and CMV/EBV infection.