Comparable Survival Outcomes in Hla-Matched and Haploidentical Hematopoietic Stem Cell Transplantation for Severe Aplastic Anemia Patients Aged 40-50: A Cbmtr Registry-Based Propensity Score Matching Analysis Over the Last Decade
Government of the People's Republic of China - Medical Center of Hematology; Government of the People's Republic of China - Department of Hematology; Government of the People's Republic of China - State Key Laboratory of Trauma, Burns and Combined Injury
Peking University - Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation; Southern Medical University - Nanfang Hospital; Peking University - Peking-Tsinghua Center for Life Sciences; Chinese Academy of Medical Sciences - Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies; Peking University - Institute of Hematology
Our study includes 278 patients aged between 40 and 50 years from 29 centers who received allogeneic hematopoietic stem cell transplantation (alloHSCT) from MSDs (n=106) and HIDs (n=172) over the last decade. Univariate analysis revealed that HID recipients was associated with more serious disease severity, a delayed alloHSCT after diagnosis, a higher pretransplant transfusion burden and poor performance status pre-transplant than MSD recipients in clinical settings. After these pretransplant clinical factors were well balanced following propensity score-matching (PSM), 80 matched pairs were selected for further analysis. Following PSM, the cumulative incidences of neutrophil were comparable between two matched groups (P = 0.14), while the 100-day engraftment rates of platelet were significant lower in HID-HCT (P < 0.001); The HID cohort showed higher cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) compared with MSD group (P = 0.04). In contrast, the incidence of severe (grade III-IV) acute GVHD and chronic GVHD were not statistically significant (severe acute GVHD P = 0.10; chronic GVHD P = 0.28). Our study showed comparable overall survival (OS) (P = 0.14); failure free survival (FFS) (P = 0.23); GVHD-free/relapse-free survival (GRFS) (P = 0.18) between matched HID and MSD recipients. In conclusion, our data indicates that alloHSCT from an HID should be considered for SAA patients between 40-50 years old who do not have an MSD.
Note:
Funding Declaration: This work was supported by the Peking University People’s Hospital Research and
Development Funds (RS2023-02).
Conflicts of Interest: None.
Ethical Approval: The study was approved
by each institutional review board at the 29 participating institutions. Written informed consent
was obtained from all patients/legal guardians, in accordance with the Declaration
of Helsinki.
Xu, Zheng-Li and Zhang, Yu-Ping and Ye, Bao-dong and Zhao, Xin and Zhou, Ming and Lu, Peihua and Sun, Zi-Min and Li, Xin and Jiang, Er-Lie and Liu, Dai-Hong and Xu, Yajing and Zhou, Fang and Liu, Li and Zhang, Xi and Song, Xian-Ming and Zhang, Jian-ping and Yi, Hai and Zhang, Xue-Jun and Ran, Xuehong and Su, Guo-Hong and Zhang, Yan-Ming and Chen, Jieping and Huang, Jin-Xiong and Wang, Chun and Yang, Hai-Ping and He, Pengcheng and Su, Nan and Guo, Ziwen and Tong, Wu and Bai, Guanchen and Fan, Sheng-Jin and Huang, Xiao-Jun and Wang, Shunqing and Xu, Lan-Ping, Comparable Survival Outcomes in Hla-Matched and Haploidentical Hematopoietic Stem Cell Transplantation for Severe Aplastic Anemia Patients Aged 40-50: A Cbmtr Registry-Based Propensity Score Matching Analysis Over the Last Decade. Available at SSRN: https://ssrn.com/abstract=5039836 or http://dx.doi.org/10.2139/ssrn.5039836
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