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Unmanipulated Haploidentical Hematopoietic Stem Cell Transplantation Achieved Outcomes Comparable With Matched Unrelated Donor Transplantation in Young Acquired Severe Aplastic Anemia.
Biol Blood Marrow Transplant. 2018 09; 24(9):1881-1887.BB

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 significant differences were observed between haplo-HSCT and MUD HSCT cohorts in 3-year overall survival (80.3% ± 5.1% versus 89.6% ± 7.0%, P = .210), disease-free survival (76.4% ± 5.1% versus 89.4% ± 7.7%, P = .127), and GVHD-free failure-free survival (79.0% ± 8.6% versus 71.6% ± 9.3%, P = .976). Thus, haplo-HSCT, as salvage therapy, achieved similar outcomes as MUD HSCT in young SAA patients, thereby rendering it as an effective and safe option for SAA.

Authors+Show Affiliations

Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China.Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, Hebei, China. Electronic address: dr_ludaopei@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29772350

Citation

Lu, Yue, et al. "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, vol. 24, no. 9, 2018, pp. 1881-1887.
Lu Y, Sun RJ, Zhao YL, et al. Unmanipulated Haploidentical Hematopoietic Stem Cell Transplantation Achieved Outcomes Comparable With Matched Unrelated Donor Transplantation in Young Acquired Severe Aplastic Anemia. Biol Blood Marrow Transplant. 2018;24(9):1881-1887.
Lu, Y., Sun, R. J., Zhao, Y. L., Xiong, M., Cao, X. Y., Zhang, J. P., Wei, Z. J., Zhou, J. R., Liu, D. Y., & Lu, D. P. (2018). 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, 24(9), 1881-1887. https://doi.org/10.1016/j.bbmt.2018.05.015
Lu Y, et al. Unmanipulated Haploidentical Hematopoietic Stem Cell Transplantation Achieved Outcomes Comparable With Matched Unrelated Donor Transplantation in Young Acquired Severe Aplastic Anemia. Biol Blood Marrow Transplant. 2018;24(9):1881-1887. PubMed PMID: 29772350.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unmanipulated Haploidentical Hematopoietic Stem Cell Transplantation Achieved Outcomes Comparable With Matched Unrelated Donor Transplantation in Young Acquired Severe Aplastic Anemia. AU - Lu,Yue, AU - Sun,Rui-Juan, AU - Zhao,Yan-Li, AU - Xiong,Min, AU - Cao,Xing-Yu, AU - Zhang,Jian-Ping, AU - Wei,Zhi-Jie, AU - Zhou,Jia-Rui, AU - Liu,De-Yan, AU - Lu,Dao-Pei, Y1 - 2018/05/14/ PY - 2018/03/03/received PY - 2018/05/09/accepted PY - 2018/5/18/pubmed PY - 2019/7/3/medline PY - 2018/5/18/entrez KW - Haploidentical donor KW - Hematopoietic stem cell transplantation KW - Matched unrelated donor KW - Young acquired severe aplastic anemia SP - 1881 EP - 1887 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol. Blood Marrow Transplant. VL - 24 IS - 9 N2 - 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 significant differences were observed between haplo-HSCT and MUD HSCT cohorts in 3-year overall survival (80.3% ± 5.1% versus 89.6% ± 7.0%, P = .210), disease-free survival (76.4% ± 5.1% versus 89.4% ± 7.7%, P = .127), and GVHD-free failure-free survival (79.0% ± 8.6% versus 71.6% ± 9.3%, P = .976). Thus, haplo-HSCT, as salvage therapy, achieved similar outcomes as MUD HSCT in young SAA patients, thereby rendering it as an effective and safe option for SAA. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/29772350/Unmanipulated_Haploidentical_Hematopoietic_Stem_Cell_Transplantation_Achieved_Outcomes_Comparable_With_Matched_Unrelated_Donor_Transplantation_in_Young_Acquired_Severe_Aplastic_Anemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(18)30267-2 DB - PRIME DP - Unbound Medicine ER -