Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter study
Abstract Background Haploidentical transplantation has been proposed as an effective treatment for severe aplastic anemia (SAA). The majority of patients have more than one HLA-haploidentical donor. Herein, we compared the outcomes between different donor-recipient relationships for optimal haploide...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | Journal of Hematology & Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13045-019-0775-9 |
| _version_ | 1818478133524824064 |
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| author | Lan-Ping Xu Shun-Qing Wang Yan-Ru Ma Su-Jun Gao Yi-Fei Cheng Yuan-Yuan Zhang Wen-Jian Mo Xiao-Dong Mo Yu-Ping Zhang Chen-Hua Yan Yu-Hong Chen Ming Zhou Yu Wang Xiao-Hui Zhang Kai-Yan Liu Xiao-Jun Huang |
| author_facet | Lan-Ping Xu Shun-Qing Wang Yan-Ru Ma Su-Jun Gao Yi-Fei Cheng Yuan-Yuan Zhang Wen-Jian Mo Xiao-Dong Mo Yu-Ping Zhang Chen-Hua Yan Yu-Hong Chen Ming Zhou Yu Wang Xiao-Hui Zhang Kai-Yan Liu Xiao-Jun Huang |
| author_sort | Lan-Ping Xu |
| collection | DOAJ |
| description | Abstract Background Haploidentical transplantation has been proposed as an effective treatment for severe aplastic anemia (SAA). The majority of patients have more than one HLA-haploidentical donor. Herein, we compared the outcomes between different donor-recipient relationships for optimal haploidentical donor selection in acquired SAA. Methods We conducted a multicenter study based on a registered database of 392 patients with SAA treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) between 2006 and 2018. In total, 223 patients received grafts from father donors, 47 from mother donors, 91 from siblings, 29 from children, and 2 from collateral donors. Results Of the 381 patients who survived more than 28 days, 379 (99.5%) recipients were engrafted. The 2-year overall survival (OS) was 86.6 ± 2.5%, 87.1 ± 4.9%, 84.3 ± 3.9%, and 92.2 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.706). The 2-year failure-free survival (FFS) was 82.8 ± 2.7%, 86.7 ± 5.1%, 80.8 ± 4.2%, and 92.5 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.508). There was no difference in the incidence of either acute or chronic graft-versus-host disease (GVHD) among the different donor sources in multivariate analyses. There were also no differences in the OS or FFS among the different donor sources in the Cox regression analysis. However, OS was significantly better in the patients with a shorter history of aplastic anemia (< 12 months), better performance status (ECOG scores 0–1), or moderate graft mononuclear cell (MNC) counts (6–10 × 108/kg), and in female recipients with male donors. The FFS was also higher in patients with a shorter history of aplastic anemia (< 12 months) and better performance status (ECOG scores 0–1). Conclusions Fathers, mothers, siblings, and children are all suitable haploidentical donors for patients with SAA. |
| first_indexed | 2024-12-10T09:44:30Z |
| format | Article |
| id | doaj.art-21462ae908c8435b98eae7fa9f232b85 |
| institution | Directory Open Access Journal |
| issn | 1756-8722 |
| language | English |
| last_indexed | 2024-12-10T09:44:30Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Hematology & Oncology |
| spelling | doaj.art-21462ae908c8435b98eae7fa9f232b852022-12-22T01:53:53ZengBMCJournal of Hematology & Oncology1756-87222019-09-0112111110.1186/s13045-019-0775-9Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter studyLan-Ping Xu0Shun-Qing Wang1Yan-Ru Ma2Su-Jun Gao3Yi-Fei Cheng4Yuan-Yuan Zhang5Wen-Jian Mo6Xiao-Dong Mo7Yu-Ping Zhang8Chen-Hua Yan9Yu-Hong Chen10Ming Zhou11Yu Wang12Xiao-Hui Zhang13Kai-Yan Liu14Xiao-Jun Huang15National Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalDepartment of Hematology, Guangzhou First People’s Hospital, School of Medicine, South China University of TechnologyNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalThe First Hospital of Jilin UniversityNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalDepartment of Hematology, Guangzhou First People’s Hospital, School of Medicine, South China University of TechnologyNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalDepartment of Hematology, Guangzhou First People’s Hospital, School of Medicine, South China University of TechnologyNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalDepartment of Hematology, Guangzhou First People’s Hospital, School of Medicine, South China University of TechnologyNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalNational Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People’s HospitalAbstract Background Haploidentical transplantation has been proposed as an effective treatment for severe aplastic anemia (SAA). The majority of patients have more than one HLA-haploidentical donor. Herein, we compared the outcomes between different donor-recipient relationships for optimal haploidentical donor selection in acquired SAA. Methods We conducted a multicenter study based on a registered database of 392 patients with SAA treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) between 2006 and 2018. In total, 223 patients received grafts from father donors, 47 from mother donors, 91 from siblings, 29 from children, and 2 from collateral donors. Results Of the 381 patients who survived more than 28 days, 379 (99.5%) recipients were engrafted. The 2-year overall survival (OS) was 86.6 ± 2.5%, 87.1 ± 4.9%, 84.3 ± 3.9%, and 92.2 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.706). The 2-year failure-free survival (FFS) was 82.8 ± 2.7%, 86.7 ± 5.1%, 80.8 ± 4.2%, and 92.5 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.508). There was no difference in the incidence of either acute or chronic graft-versus-host disease (GVHD) among the different donor sources in multivariate analyses. There were also no differences in the OS or FFS among the different donor sources in the Cox regression analysis. However, OS was significantly better in the patients with a shorter history of aplastic anemia (< 12 months), better performance status (ECOG scores 0–1), or moderate graft mononuclear cell (MNC) counts (6–10 × 108/kg), and in female recipients with male donors. The FFS was also higher in patients with a shorter history of aplastic anemia (< 12 months) and better performance status (ECOG scores 0–1). Conclusions Fathers, mothers, siblings, and children are all suitable haploidentical donors for patients with SAA.http://link.springer.com/article/10.1186/s13045-019-0775-9Haploidentical transplantationDonor selectionAcquired severe aplastic anemia |
| spellingShingle | Lan-Ping Xu Shun-Qing Wang Yan-Ru Ma Su-Jun Gao Yi-Fei Cheng Yuan-Yuan Zhang Wen-Jian Mo Xiao-Dong Mo Yu-Ping Zhang Chen-Hua Yan Yu-Hong Chen Ming Zhou Yu Wang Xiao-Hui Zhang Kai-Yan Liu Xiao-Jun Huang Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter study Journal of Hematology & Oncology Haploidentical transplantation Donor selection Acquired severe aplastic anemia |
| title | Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter study |
| title_full | Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter study |
| title_fullStr | Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter study |
| title_full_unstemmed | Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter study |
| title_short | Who is the best haploidentical donor for acquired severe aplastic anemia? Experience from a multicenter study |
| title_sort | who is the best haploidentical donor for acquired severe aplastic anemia experience from a multicenter study |
| topic | Haploidentical transplantation Donor selection Acquired severe aplastic anemia |
| url | http://link.springer.com/article/10.1186/s13045-019-0775-9 |
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