Relationship of Cell Compositions in Allografts with Outcomes after Haploidentical Transplantation for Acquired Severe Aplastic Anemia

Abstract

Background:The dose of certain cell types in allografts affects engraftment kinetics and clinical outcomes after allogeneic stem cell transplantation (SCT). Hence, the present study investigated the association of cell compositions in allografts with outcomes after unmanipulated haploidentical SCT (haplo-SCT) for patients with acquired severe aplastic anemia (SAA).Methods:A total of 131 patients with SAA who underwent haplo-SCT were retrospectively enrolled. Cell subsets in allografts were determined using flow cytometry. To analyze the association of cellular compositions and outcomes, Mann–Whitney U nonparametric tests were conducted for patient age, sex, weight, human leukocyte antigen mismatched loci, ABO-matched status, patient ABO blood type, donor-recipient sex match, donor-recipient relationship, and each graft component. Multivariate analysis was performed using logistic regression to determine independent influence factors involving dichotomous variables selected from the univariate analysis.Results:A total of 126 patients (97.7%) achieved neutrophil engraftment, and 121 patients (95.7%) achieved platelet engraftment. At 100 days after transplantation, the cumulative incidence of II–IV acute graft-versus-host disease (GVHD) was 32.6%. After a median follow-up of 842 (range: 124–4110) days for surviving patients, the cumulative incidence of total chronic GVHD at 3 years after transplantation was 33.7%. The probability of overall survival at 3 years was 83.0%. Multivariate analysis showed that higher total doses of CD14+ (P = 0.018) and CD34+ cells (P < 0.001) were associated with a successful platelet engraftment. A successful platelet was associated with superior survival (P < 0.001). No correlation of other cell components with outcomes was observed.Conclusions:These results provide evidence and explain that higher doses of CD34+ and CD14+ cells in haploidentical allografts positively affect platelet engraftment, contributing to superior survival for patients with SAA.

Haploidentical transplantation in pediatric non‐malignant diseases: A retrospective analysis on behalf of the Spanish Group for Hematopoietic Transplantation (GETH)

“…This study reports the accumulated experience of all Spanish centers performing haplo‐HSCTs for the pediatric population with NMDs, which corresponds to 13.9% of the cumulative activity of haplo‐HSCTs 30 . In our study, the 2‐year OS of 44.9% was lower than that in our reported series on malignant disorders (55.1%) 26 and that recently reported from various groups in NMDs, which also differed according to the diagnosis 2,12,28,29,36‐39 . These differences can be explained by the fact that haplo‐HSCT in NMDs was not a routine practice in the first decade of this study (2001‐2010), with matched sibling donors the first option for PIDs and other NMDs.…”

“…30 In our study, the 2-year OS of 44.9% was lower than that in our reported series on malignant disorders (55.1%) 26 and that recently reported from various groups in NMDs, which also differed according to the diagnosis. 2,12,28,29,[36][37][38][39] These differences can be explained by the fact that haplo-HSCT in NMDs was not a routine practice in the first decade of this study (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010), with matched sibling donors the first option for PIDs and other NMDs. It should also be noted that the patients in our series were at major risk because, in most cases, there can be significant delays between the diagnosis and transplantation, leading to increased cumulative morbidity, thereby contributing to high post-…”

Mesenchymal stromal cells as prophylaxis for graft-versus-host disease in haplo-identical hematopoietic stem cell transplantation recipients with severe aplastic anemia?—a systematic review and meta-analysis

“…As a result, 32 records were excluded, and 29 studies met the inclusion criteria. The included studies were divided into two groups (MSCs [31][32][33][34][35][36][37][38]; no MSCs [22,24,25,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]) based on whether they applied the MSCs or not. The selection process is illustrated in Fig.…”

Mesenchymal Stromal Cells as Prophylaxis for Graft-versus-host Disease in Haplo-identical Hematopoietic Stem Cell Transplantation Recipients With Severe Aplastic Anemia? - A Systematic Review and Meta-analysis

“…As a result, 32 records were excluded, and 29 studies met the inclusion criteria. The included studies were divided into two groups (MSCs [31][32][33][34][35][36][37][38] ; no MSCs 22,25,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] ) based on whether they applied the MSCs or not. The selection process is illustrated in Fig.…”