Optimal donor for severe aplastic anemia patient requiring allogeneic hematopoietic stem cell transplantation: A large-sample study from China

Abstract

HLA-haploidentical hematopoietic stem cell transplantation (HSCT) may be an option for severe aplastic anemia (SAA) patients. However, to date, no large-sample studies have been performed to determine which types of SAA patients are suitable for HLA-haploidentical HSCT. We retrospectively studied 189 consecutive patients with SAA who underwent HLA-identical or HLA-haploidentical HSCT at seven transplant centers in China. Propensity score matching (PSM) was applied in this study to reduce the influence of potential confounders. The 5-year overall survival (OS) rate was 72.0% in the HLA-haploidentical group and 76.5% in the HLA-identical group. The median time to achieve engraftment and the incidence of acute GVHD/chronic GVHD were not significantly different between the two groups. In the subgroup analysis, the outcome of patients older than 40 years in the HLA-haploidentical group was significantly poorer than that of patients younger than 40 years in the same group and that of patients older than 40 years in the HLA-identical group. Based on the above results, we suggest that HLA-haploidentical relative HSCT should be considered as a valid alternative option for patients younger than 40 years with SAA for whom no matched sibling donor is available.

Comparable Outcomes and Health-Related Quality of Life for Severe Aplastic Anemia: Haploidentical Combined With a Single Cord Blood Unit vs Matched Related Transplants

“…Among patients younger than 40 year, at least comparable OS and GFFS rates were observed between Haplo-cord HSCT and MRD-HSCT groups. Therefore, it was feasible to recommend the Haplo-cord HSCT for SAA patients without MRDs, which was consistent with another report ( 26 ). Patients older than 40 years had a significantly poorer prognosis in the Haplo-cord HSCT than that in the MRD-HSCT group, nevertheless, the differences were not statistically significant, probably because the number of patients in the over 40 years old subgroup were too small to draw a persuasive conclusion.…”

Comparable survival outcome between transplantation from haploidentical donor and matched related donor or unrelated donor for severe aplastic anemia patients aged 40 years and older: A retrospective multicenter cohort study

“…With the advantages of easy donor availability and short preparation time for transplantation, HID‐HSCT was regarded as a potential and promising therapy for patients without MSD and URD. Moreover, HID‐HSCT had achieved remarkable progress and showed comparable outcomes with HSCT from matched donors in younger SAA patients . Nevertheless, the outcome of HSCT from HID in SAA patients 40 years of age and older remains unknown.…”

“…Moreover, HID-HSCT had achieved remarkable progress and showed comparable outcomes with HSCT from matched donors in younger SAA patients. [8][9][10][11][12] Nevertheless, the outcome of HSCT from HID in SAA patients 40 years of age and older remains unknown.…”

Comparable Outcome with a Faster Engraftment of Optimized Haploidentical Hematopoietic Stem Cell Transplantation Compared with Transplantations from Other Donor Types in Pediatric Acquired Aplastic Anemia

“…Our data demonstrate that ex vivo T cellÀdepleted HFD-HCT had comparable outcomes in children and adolescents with acquired SAA with MRD-or URD-HCT. Although few reports have compared outcomes of HCT from HFD and MSD in SAA, this is the first report comparing HCT outcomes of consecutive pediatric and adolescents patients with SAA based on different donors including URD [20][21][22].…”