Long-term outcome of HLA-haploidentical hematopoietic SCT without in vitro T-cell depletion for adult severe aplastic anemia after modified conditioning and supportive therapy.
HLA-haploidentical hematopoietic SCT (HSCT) is an option for severe aplastic anemia (SAA) patients. Here, we evaluated the outcomes of 26 adult-SAA patients who received HLA-haploidentical HSCT in five transplant centers in southwestern China. Most of the patients in this study failed prior therapy and were transfused heavily before the transplantation. The patients received fludarabine+cyclophosphamide+antithymocyte globulin as conditioning regimens and then unmanipulated peripheral blood plus marrow transplantation. Micafungin, i.v. Ig and recombinant human TPO were used for post-grafting infection prevention and supportive care. Of 26 patients, 25 achieved engraftment at a median of 13 days (range, 11-19 days) after HSCT. One of 25 patients experienced graft rejection and did not achieve sustained engraftment after second HSCT. Therefore, the final engraftment rate was 92.3%. Three of 25 (12%) patients developed acute GVHD, 10 of 25 (40%) patients developed chronic GVHD (9 with limited whereas the other with extensive). The OS rate was 84.6% and the average follow-up time was 1313.2 (738-2005) days for surviving patients. This encouraging result suggests that HLA-haploidentical HSCT is an effective therapeutic option for adults with acquired SAA if an HLA-identical donor is not available.
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
L
L
Gao
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Y
Y
Li
Department of Health Statistics, College of Military Preventive Medicine, Third Military Medical University, Chongqing, China.
Y
Y
Zhang
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
X
X
Chen
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
L
L
Gao
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
C
C
Zhang
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Y
Y
Liu
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
P
P
Kong
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Q
Q
Wang
Department of Hematology, General Hospital of Chengdu Military Region of PLA, Sichuan, China.
Y
Y
Su
Department of Hematology, Sichuan Provincial Peoples Hospital, Sichuan, China.
C
C
Wang
Department of Hematology, General Hospital of Kunming Military Region of PLA, Yunnan, China.
S
S
Wang
Department of Hematology, Second Yunnan Provincial peoples hospital, Yunnan, China.
B
B
Li
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
A
A
Sun
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
X
X
Du
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
D
D
Zeng
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
J
J
Li
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
H
H
Liu
Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
X
X
Zhang
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy*; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006648:Histocompatibility; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D008212:Lymphocyte Depletion / Q000379:methods*; D008297:Male; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D006680:HLA Antigens