Acute graft-versus-host disease after compatriots HLA sibling-matched versus haploidentical allogeneic peripheral blood stem cell transplantation

doi:10.3969/j.issn.2095-4344.2014.14.015

Abstract

Abstract:

BACKGROUND: In recent years, the haploidentical allogeneic peripheral blood stem cell transplantation is popular as its donor source in clinical application. Acute graft-versus-host disease is still the main factor influencing the success rate of transplantation.
OBJECTIVE: To compare occurrence characteristics of acute graft-versus-host disease after compatriots HLA sibling-matched versus haploidentical allogeneic peripheral blood stem cell transplantation and to discuss the way to reduce the occurrence of acute graft-versus-host disease and the clinical significance of haploidentical allogeneic peripheral blood stem cell transplantation.
METHODS: Fifty-two patients undergoing allogeneic peripheral blood stem cell transplantation were retrospectively analyzed, including 31 cases of compatriots HLA sibling-matched cell transplantation and 21 cases of haploidentical allogeneic peripheral blood stem cell transplantation. Conditioning regimen in HLA sibling-matched patients was busulfan/cyclophosphamide+anti-thymocyte globulin for HLA sibling haploid-matched patients, and busulfan/ cyclophosphamide for compatriots HLA sibling-matched patients. Short-term methotrexate+cyclosporine A+mycophenolate mofetil was used for prevention of graft-versus-host disease.
RESULTS AND CONCLUSION: All patients successfully obtained persistent stem cell transplantation. 48% patients (12/52) suffered from acute graft-versus-host disease, and 23% patients (12/52) developed grade III-IV acute graft-versus-host disease. The cumulative incidence of acute graft-versus-host disease was 39% (12/31) in the sibling-matched group and 62% (12/21) in the sibling haploid-matched group (P > 0.05). The cumulative incidence of grade III-IV acute graft-versus-host disease was 10% (3/31) in the sibling-matched group and 42% (9/21) in the sibling haploid-matched group (P < 0.05). Type distribution of acute graft-versus-host disease occurring at 0-30 days, 31-60 days, 61-100 days after cell transplantation showed no difference (P > 0.05). The incidence of acute graft-versus-host disease occurring with 30 days after transplantation was higher than those within 31-60 and 61-100 days after cell transplantation. There were no differences in recurrence rate and 2-year disease-free survival in the patients with or without acute graft-versus-host disease (P > 0.05). Recurrence rate showed no difference between the sibling-matched group and sibling haploid-matched group, but the 2-year disease-free survival rate was higher in the former group (P < 0.05). Therefore, HLA haploidentical transplantation is a good way to increase the source of donors for the treatment of haematological malignancies.

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

全文链接：

Key words: stem cells, hematopoietic stem cell transplantation, hematologic neoplasms, graft vs host disease, HLA antigens

CLC Number:

R394.2

Zheng Jing-jing, Xie Xin-sheng, Wan Ding-ming, Sun Hui, Sun Ling. Acute graft-versus-host disease after compatriots HLA sibling-matched versus haploidentical allogeneic peripheral blood stem cell transplantation[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(14): 2226-2231.

Figures/Tables 2

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