[HLA- haploidentical donor hematopoietic transplantation for severe aplastic anemia achieved comparable outcomes with HLA- unrelated donor transplantation]

Zhonghua Xue Ye Xue Za Zhi. 2016 Jan;37(1):35-8. doi: 10.3760/cma.j.issn.0253-2727.2016.01.007.
[Article in Chinese]

Abstract

Objective: To evaluate the efficacy of HLA- haploidentical donor hematopoietic transplantation (Haplo- HSCT)for severe aplastic anemia (SAA)by compared with the same period of unrelated donor transplantation (UD- HSCT).

Methods: Of a cohort of 50 SAA patients between September 2012 and July 2014, 26 patients underwent UD- HSCT and 24 patients Haplo- HSCT.

Results: OS rate was 91.3% with a median follow-up of 9 (2-26)months. According to transplant type, there was no significant difference between UD- and Haplo-HSCT (96.1%vs 86.0%,P=0.30). 3 of 50 (6%)patients had primary engraft failure. Haplo- HSCT developed higher significantly incidence of Ⅱ- Ⅳ aGVHD (37.5%vs 3.83%,P=0.003)and cGVHD (37.5%vs 15.3%,P=0.030)than UD-HSCT. Haplo-HSCT also had significantly higher incidences of CMV viremia (78.2%vs 46.1%,P=0.005)and EBV viremia (43.1%vs 16.0%,P=0.040), respectively than UD-HSCT. But the incidences of hemorrhagic cystitis were similar between two transplant types (39.1%vs 23.0%,P=0.120).

Conclusion: This study showed favorable outcome of Haplo-HSCT for SAA, which was comparable with UD-HSCT.

目的: 评价亲缘半相合造血干细胞移植(Haplo-HSCT)治疗重型再生障碍性贫血(SAA)的疗效,并且与同期进行的无关供者造血干细胞移植(UD-HSCT)进行比较。

方法: 回顾性分析2012年9月至2014年7月接受替代供者造血干细胞移植的50例SAA患者临床资料;其中24例接受Haplo-HSCT, 26例接受UD-HSCT。

结果: 中位随访时间9(2~26)个月,总生存(OS)率为91.3%。UD-HSCT组和Haplo-HSCT组OS率分别为96.1%和86.0%(P=0.30)。3例(6%)患者原发植入失败。Haplo-HSCT组患者Ⅱ~Ⅳ度急性移植物抗宿主病、慢性移植物抗宿主病、CMV血症、EBV血症发生率分别为37.5%、37.5%、78.2%及43.1%,均明显高于UD-HSCT组(3.83%、15.3%、46.1%及16.0%)(P值分别为0.003、0.030、0.005、0.040);出血性膀胱炎发生率差异无统计学意义(39.1%对23.0%,P=0.120)。

结论: Haplo-HSCT治疗SAA OS率较高,疗效与UD-HSCT相近。

MeSH terms

  • Anemia, Aplastic / therapy*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Incidence
  • Treatment Outcome
  • Unrelated Donors*