Long-term outcomes of HLA-haploidentical stem cell transplantation based on an FBCA conditioning regimen compared with those of HLA-identical sibling stem cell transplantation for haematologic malignancies.
A comparison was conducted of 213 patients with haematologic malignancies who underwent HLA-identical sibling (n=108) or HLA-haploidentical (n=105) haematopoietic cell transplantation (haplo-HCT) at our centre. The conditioning regimen included fludarabine, busulphan, cyclophosphamide and antilymphocyte globulin (ATG) (FBCA). The total dose of ATG differed between identical and haploidentical groups (3.75 mg/kg versus 12.5 mg/kg). The cumulative incidences of grade II-IV acute GvHD in the identical and haploidentical groups were 20.4% and 21.9% (P=0.73), and 2-year cumulative incidences of chronic GvHD were 36.4% and 24.1% (P=0.17), respectively. The 3-year probabilities of non-relapse mortality for identical and haploidentical groups were 20.5% and 34.9% (P=0.048), and for relapse were 22.2% and 21.0% (P=0.85), respectively. The 3-year overall survivals in the identical and haploidentical groups were 62.6% and 52.6% (P=0.054), whereas the 3-year disease-free survivals were 54.7% and 43.1% (P=0.14), respectively. In the multivariate analysis, patients in the high-risk group exhibited reduced survival, and the higher dose of mononuclear or CD34+ cells resulted in an increase in the likelihood of survival. In conclusion, haplo-HCT based on an FBCA conditioning regimen could achieve nearly comparable outcomes to HLA-identical sibling HCT.
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
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H
Long
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
Z G
ZG
Lu
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
C Y
CY
Song
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
Y X
YX
Huang
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
J H
JH
Xu
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
J X
JX
Xu
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
L
L
Deng
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
S F
SF
Tu
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
Y Z
YZ
He
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
X
X
Lin
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
K Y
KY
Guo
Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, People's Republic of China.
B Y
BY
Wu
D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D035781:Siblings; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods; D000075442:Transplantation, Haploidentical / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome; D055815:Young Adult
D018952:Antigens, CD34