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[Comparison of Frontline Haploidentical Hematopoietic Stem Cell Transplantation and Salvage Haploidentical Hematopoietic Stem Cell Transplantation for Patients with Severe Aplastic Anemia].
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Oct; 28(5):1683-1688.ZS

Abstract

OBJECTIVE

To compare the clinical efficacy between frontline haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) and salvage haplo-HSCT for patients with severe aplastic anemia (SAA).

METHODS

A total of 39 patients with severe aplastic anemia or very severe aplastic anemia from May 1st, 2013 to December 31st, 2018 were analyzed retrospectively. All of them underwent bone marrow + peripheral blood hemopoietic stem cell transplantation. There were 20 cases who accepted frontline haplo-HSCT for a median course of 1 (1-3) month, and 19 cases who accepted salvage haplo-HSCT for a median course of 72 (6-168) months. Conditioning regimen: 22 cases received Flu/Cy+ATG, and 17 cases received Bu/Cy+ATG.

RESULTS

The time of hematopoietic reconstitution, infection rate, and grade I-Ⅱ and Ⅲ-Ⅳ acute/chronic graft versus host disease showed no statistically significance between the frontline haplo-HSCT group and the salvage haplo-HSCT group. In the frontline haplo-HSCT group, 1 case (5%) failed in second engraftment, in the salvage haplo-HSCT group 2 cases (10.5%) failed in primary engraftment and 4 cases (21.1%) in second engraftment. The incidence of engraftment failure was higher in the salvage haplo-HSCT group than that in the frontline haplo-HSCT group (P=0.04). The median time of follow-up after allo-HSCT was 45 months (ranging from 3 to 92). The mortality was 10% (2/20) in the frontline haplo-HSCT group, and 42.1% (8/19) in the salvage haplo-HSCT group. The estimated 5-year failure-free survival rate (FFS) of the frontline haplo-HSCT group was higher than that of the salvage haplo-HSCT group (90% vs 57.4%) (P=0.02).

CONCLUSION

The frontline haplo-HSCT is an effective and safe approach for the patients with severe aplastic anemia who lack a HLA-matched sibling donor.

Authors+Show Affiliations

Department of Hematology, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, Shaanxi Province, China.Department of Hematology, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, Shaanxi Province, China.Department of Hematology, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, Shaanxi Province, China.Department of Hematology, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, Shaanxi Province, China.Department of Hematology, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, Shaanxi Province, China.Department of Hematology, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, Shaanxi Province, China.Department of Hematology, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, Shaanxi Province, China,E-mail: liuli1@medmail.com.cn.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

33067974

Citation

Xiao, Fang, et al. "[Comparison of Frontline Haploidentical Hematopoietic Stem Cell Transplantation and Salvage Haploidentical Hematopoietic Stem Cell Transplantation for Patients With Severe Aplastic Anemia]." Zhongguo Shi Yan Xue Ye Xue Za Zhi, vol. 28, no. 5, 2020, pp. 1683-1688.
Xiao F, Liu Q, Fan D, et al. [Comparison of Frontline Haploidentical Hematopoietic Stem Cell Transplantation and Salvage Haploidentical Hematopoietic Stem Cell Transplantation for Patients with Severe Aplastic Anemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020;28(5):1683-1688.
Xiao, F., Liu, Q., Fan, D., Guo, H. X., Yan, X. Q., Zhao, H., & Liu, L. (2020). [Comparison of Frontline Haploidentical Hematopoietic Stem Cell Transplantation and Salvage Haploidentical Hematopoietic Stem Cell Transplantation for Patients with Severe Aplastic Anemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi, 28(5), 1683-1688. https://doi.org/10.19746/j.cnki.issn.1009-2137.2020.05.042
Xiao F, et al. [Comparison of Frontline Haploidentical Hematopoietic Stem Cell Transplantation and Salvage Haploidentical Hematopoietic Stem Cell Transplantation for Patients With Severe Aplastic Anemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020;28(5):1683-1688. PubMed PMID: 33067974.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Comparison of Frontline Haploidentical Hematopoietic Stem Cell Transplantation and Salvage Haploidentical Hematopoietic Stem Cell Transplantation for Patients with Severe Aplastic Anemia]. AU - Xiao,Fang, AU - Liu,Qiang, AU - Fan,Dan, AU - Guo,Huan-Xu, AU - Yan,Xue-Qian, AU - Zhao,Hui, AU - Liu,Li, PY - 2020/10/17/entrez PY - 2020/10/18/pubmed PY - 2020/10/21/medline SP - 1683 EP - 1688 JF - Zhongguo shi yan xue ye xue za zhi JO - Zhongguo Shi Yan Xue Ye Xue Za Zhi VL - 28 IS - 5 N2 - OBJECTIVE: To compare the clinical efficacy between frontline haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) and salvage haplo-HSCT for patients with severe aplastic anemia (SAA). METHODS: A total of 39 patients with severe aplastic anemia or very severe aplastic anemia from May 1st, 2013 to December 31st, 2018 were analyzed retrospectively. All of them underwent bone marrow + peripheral blood hemopoietic stem cell transplantation. There were 20 cases who accepted frontline haplo-HSCT for a median course of 1 (1-3) month, and 19 cases who accepted salvage haplo-HSCT for a median course of 72 (6-168) months. Conditioning regimen: 22 cases received Flu/Cy+ATG, and 17 cases received Bu/Cy+ATG. RESULTS: The time of hematopoietic reconstitution, infection rate, and grade I-Ⅱ and Ⅲ-Ⅳ acute/chronic graft versus host disease showed no statistically significance between the frontline haplo-HSCT group and the salvage haplo-HSCT group. In the frontline haplo-HSCT group, 1 case (5%) failed in second engraftment, in the salvage haplo-HSCT group 2 cases (10.5%) failed in primary engraftment and 4 cases (21.1%) in second engraftment. The incidence of engraftment failure was higher in the salvage haplo-HSCT group than that in the frontline haplo-HSCT group (P=0.04). The median time of follow-up after allo-HSCT was 45 months (ranging from 3 to 92). The mortality was 10% (2/20) in the frontline haplo-HSCT group, and 42.1% (8/19) in the salvage haplo-HSCT group. The estimated 5-year failure-free survival rate (FFS) of the frontline haplo-HSCT group was higher than that of the salvage haplo-HSCT group (90% vs 57.4%) (P=0.02). CONCLUSION: The frontline haplo-HSCT is an effective and safe approach for the patients with severe aplastic anemia who lack a HLA-matched sibling donor. SN - 1009-2137 UR - https://www.unboundmedicine.com/medline/citation/33067974/[Comparison_of_Frontline_Haploidentical_Hematopoietic_Stem_Cell_Transplantation_and_Salvage_Haploidentical_Hematopoietic_Stem_Cell_Transplantation_for_Patients_with_Severe_Aplastic_Anemia]_ L2 - http://www.diseaseinfosearch.org/result/556 DB - PRIME DP - Unbound Medicine ER -