Unmanipulated haploidentical donor and matched unrelated donor hematopoietic stem cell transplantation in patients with paroxysmal nocturnal hemoglobinuria: a single-center study

Leuk Lymphoma. 2022 May;63(5):1211-1219. doi: 10.1080/10428194.2021.2015588. Epub 2021 Dec 16.

Abstract

We analyzed the outcomes of 32 patients with paroxysmal nocturnal hemoglobinuria (PNH) who underwent either a haploidentical donor (HID) or a matched unrelated donor (MUD) hematopoietic stem cell transplantation (HSCT). Seventeen patients received an HSCT from an HID and 15 patients received an HSCT from an MUD. The median follow-up time of the surviving patients was 36 months (range: 12-96 months). No significant differences were observed in the 3-year overall survival (OS) between the HID and MUD cohorts (74.1%±11.4% vs. 93.3%±6.4%, respectively, p=.222) or in the 3-year failure-free survival (68.8%±11.8% vs. 86.7%±8.8%, respectively, p=.307). Treatment-related mortality occurred in five patients. A univariate analysis of risk factors revealed platelet engraftment failure negatively impacted OS and FFS. We conclude that HID and MUD-HSCT are feasible and can be effective options for those PNH patients with concomitant bone marrow failure, recurrent life-threatening thrombosis, and uncontrollable hemolysis.

Keywords: Haploidentical donor; hematopoietic stem cell transplantation; matched unrelated donor; paroxysmal nocturnal hemoglobinuria.

MeSH terms

  • Bone Marrow Failure Disorders
  • Graft vs Host Disease* / etiology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hemoglobinuria, Paroxysmal* / diagnosis
  • Hemoglobinuria, Paroxysmal* / therapy
  • Humans
  • Pancytopenia* / etiology
  • Retrospective Studies
  • Transplantation Conditioning
  • Unrelated Donors