Wu Hongfei1,2, Wan Dingming1, Guo Rong1, Wang Chong1, Sun Ling1, Sun Hui1, Jiang Zhongxing1, Wang Xianjing2, Hou Shao-ying1 and Xie Xinsheng1*
1 Department of Hematology, The First Affiliated Hospital of Zhengzhou University, China
2 Department of Hematology, The Third People’s Hospital of Zhengzhou, China
Objective: To investigate the efficacy and prognosis of Haploidentical Allogeneic Hematopoietic Stem Cell Transplantation (Haplo-HSCT) for Severe Aplastic Anemia (SAA).
Methods: The clinical data of 40 SAA cases (29 with SAA-I, 9 with SAA-II, 2 with posthepatisis SAA) with Haplo-HSCT from September 2013 to February 2018 were retrospectively analyzed. 33 SAA patients received peripheral blood hematopoietic stem cells, 7 SAA patients combined with bone marrow hematopoietic stem cells. The conditioning regimen contained cyclophosphamide, fludarabine and antithymocyte globulin, with or without busulfan or low dose total body irradiation. Cyclosporin A, short-term methotrexate and mycophenolate mofetil were used for preventing Graft Versus Host Disease (GVHD).The median counts of Mononuclear Cell (MNC) and CD34+ stem cell were 5.3 (range: 2.0 to 13.5) × 108 /kg and 5.6 (range: 1.6 to 15.9) × 106 /kg, respectively.
Results: Among 40 SAA cases, hematopoiesis reconstitution was achieved in 36 cases (90.0%). The median times for myeloid engraftment and platelet engraftment were 15 (range: 10 to 25) and 17 (range: 10 to 58) days, respectively. The incidence of Acute Graft-Versus-Host Disease (aGVHD) was 35.0% ± 6.8%, grades II-IV aGVHD 20.0% ± 3.4%, and grades III-IV aGVHD 10.0% ± 6.1%. The incidence of Chronic GVHD (cGVHD) was 23.0% ± 7.4%, extensive cGVHD 11% ± 3.7%. 28 (70.0%) SAA cases alived at median follow-up time of 353 (30-1226) days, the cumulative Overall Survival (OS) was 67.8% ± 7.8%, and the average time was 883 ± 82 days, Transplantation-Related Mortality (TRM) within 100 days was 10.0% ± 3.1%.
Conclusion: Haplo-HSCT was an effective option for SAA patients; however, it needs to be studied in a large number of cases for enhancing overall survival.
Severe aplastic anemia; Haploidentical allogeneic hematopoietic stem cell transplantation; Human leukocyte antigen
Hongfei W, Dingming W, Rong G, Chong W, Ling S, Hui S, et al. Efficacy of Haploidentical Allogeneic Hematopoietic Stem Cell Transplantation for 40 Cases with Severe Aplastic Anemia. Ann Stem Cell Res Ther. 2019; 3(1): 1029.