Haploidentical allogeneic hematopoietic stem cell transplantation for severe aplastic anemia: a retrospective analysis

doi:10.3969/j.issn.2095-4344.2015.36.015

Abstract

Abstract:

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is currently recognized as the first-line therapy for severe aplastic anemia. However, with the popularity of the one-child families, the source of fully matched hematopoietic stem cell transplantation is limited, so haploidentical hematopoietic stem cell transplantation is favored.

OBJECTIVE: To retrospectively compare and analyze the clinical efficacy and safety of haploidentical allogeneic hematopoietic stem cell transplantation and fully matched hematopoietic stem cell transplantation for the treatment of severe aplastic anemia.

METHODS: Clinical data of 15 patients with severe aplastic anemia (treatment group) who underwent haploidentical allogeneic hematopoietic stem cell transplantation in the Department of Hematology General Hospital of Beijing Military Region from January 2013 to January 2015 were retrospectively analyzed. Pretreatment regimen was cyclophosphamide, fludarabine, Busulfex, combined with anti-human lymphocyte immune globulin. Donors received granulocyte colony-stimulating factor, and the transplantation method was bone marrow mobilization combined with peripheral blood stem cell transplantation. Combined immunosuppressive agents including cyclosporine A, methotrexate, tacrolimus, were adopted for prevention of graft versus host disease. Another 15 cases of severe aplastic anemia undergoing fully matched hematopoietic stem cell transplantation served as control group over the same period. Complications and survival of the two groups were statistically analyzed.

RESULTS AND CONCLUSION: By the end of July 2015, the median follow-up time of the treatment group was 20.7 months (6-30 months), and hematopoietic reconstruction was achieved in all cases, including four cases of graft versus host disease, five cases of pulmonary infection, three cases of sepsis, and one case died of pulmonary infection, one cases died of sepsis, and two cases died of graft versus host disease. In the control group, the median follow-up time was 19.7 months (5-28 months), hematopoietic reconstruction was achieved in all cases. There were three cases of graft versus host disease, four cases of pulmonary infection, one case died of pulmonary infection, and two cases died of graft versus host disease. The total survival rates of the two groups were 73% and 80% respectively, with no significant difference (P=0.67). The haploidentical allogeneic hematopoietic stem cell transplantation for severe aplastic anemia is safe and effective, and the clinical efficacy is comparable to the fully matched hematopoietic stem cell transplantation.

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

Key words: Anemia, Aplastic, Hematopoietic Stem Cell Transplantation, Graft vs Host Disease

CLC Number:

R394.2

Tong Chun, Guo Zhi, Lou Jin-xing, Liu Xiao-dong, Yang Kai, He Xue-peng, Zhang Yuan, Chen Peng, Chen Hui-ren. Haploidentical allogeneic hematopoietic stem cell transplantation for severe aplastic anemia: a retrospective analysis [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(36): 5821-5826.

Figures/Tables 1

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