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Xu ZL, Xu LP, Zhang YY, Cheng YF, Mo XD, Han TT, Wang FR, Yan CH, Sun YQ, Chen YH, Tang FF, Han W, Wang Y, Zhang XH, Liu KY, Huang XJ. Mixed chimaerism is associated with poorer long-term failure-free survival among aplastic anaemia patients receiving HLA-matched donor transplantation. Bone Marrow Transplant 2023; 58:832-834. [PMID: 37041214 DOI: 10.1038/s41409-023-01974-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/13/2023]
Affiliation(s)
- Zheng-Li Xu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Lan-Ping Xu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Yuan-Yuan Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Yi-Fei Cheng
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Xiao-Dong Mo
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Ting-Ting Han
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Feng-Rong Wang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Chen-Hua Yan
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Yu-Qian Sun
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Yu-Hong Chen
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Fei-Fei Tang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Wei Han
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Yu Wang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Xiao-Hui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Kai-Yan Liu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
- National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China.
- National Clinical Research Center for Hematologic Disease, Beijing, China.
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
- Peking-Tsinghua Center for Life Sciences, Beijing, China.
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Xu ZL, Xu LP, Wu DP, Wang SQ, Zhang X, Xi R, Gao SJ, Xia LH, Yang JM, Jiang M, Wang X, Liu QF, Chen J, Zhou M, Huang XJ. Comparable long-term outcomes between upfront haploidentical and identical sibling donor transplant in aplastic anemia: a national registry-based study. Haematologica 2022; 107:2918-2927. [PMID: 35615930 PMCID: PMC9713560 DOI: 10.3324/haematol.2022.280758] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Indexed: 12/14/2022] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a curative option for severe aplastic anemia (SAA), and transplantation from identical sibling donors (ISD) has been recommended as a first-line treatment. Haploidentical donor (HID) transplantation for SAA has made great advances; thus, an increased role of HID-SCT in SAA should be considered. We performed a national registry-based analysis comparing long-term outcomes in the upfront HID or upfront ISD SCT setting. A total of 342 SAA patients were enrolled, with 183 patients receiving HID SCT and 159 receiving ISD SCT. The estimated 9-year overall survival and failure-free survival were 87.1±2.5% and 89.3±3.7% (P=0.173) and 86.5±2.6% versus 88.1±3.8% (P=0.257) for patients in the HID and ISD SCT groups, respectively. Transplantation from HID or ISD SCT has greatly improved quality of life (QoL) levels post-HSCT compared to pre-HSCT. The occurrence of chronic graft-versus-host disease was the only identified adverse factor affecting each subscale of QoL. Physical and mental component summaries in adults as well as physical, mental, social, and role well-being in children were all similar between HID and ISD SCT at 5-year time points. At the last follow-up, the proportion of returning to society was comparable between the HID and ISD groups, showing 78.0% versus 84.6% among children and 74.6% versus 81.2% among adults. These data suggest that haploidentical transplant can be considered a potential therapeutic option in the upfront setting for SAA patients in the absence of an HLA-identical related or unrelated donor.
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Affiliation(s)
- Zheng-Li Xu
- Peking University People’s Hospital, Peking University Institute of Hematology, Beijing,National Clinical Research Center for Hematologic Disease, Beijing,*Z-LX, L-PX, D-PW, S-QW contributed equally as co-first authors
| | - Lan-Ping Xu
- Peking University People’s Hospital, Peking University Institute of Hematology, Beijing,National Clinical Research Center for Hematologic Disease, Beijing,*Z-LX, L-PX, D-PW, S-QW contributed equally as co-first authors
| | - De-Pei Wu
- The First Hospital affiliated to Soochow University, Soochow,*Z-LX, L-PX, D-PW, S-QW contributed equally as co-first authors
| | - Shun-Qing Wang
- Guangzhou First People’s Hospital, Guangzhou,*Z-LX, L-PX, D-PW, S-QW contributed equally as co-first authors
| | - Xi Zhang
- Xinqiao Hospital affiliated to Third Military Medical University, Chongqing
| | - Rui Xi
- General Hospital of Lanzhou Military Region of PLA, Lanzhou
| | - Su-Jun Gao
- The First Hospital of Jilin University, Changchun
| | - Ling-Hui Xia
- Xiehe Hospital affiliated to Huazhong University of Science and Technology, Wuhan
| | - Jian-Min Yang
- Changhai Hospital affiliated to Second Military Medical University, Shanghai
| | - Ming Jiang
- The First Hsopital affiliated to Xinjiang Medical University, Urumchi
| | - Xin Wang
- Shandong Provincial Hospital, Jinan
| | - Qi-Fa Liu
- Nanfang Hospital affiliated to Southern Medical University, Guangzhou
| | - Jia Chen
- The First Hospital affiliated to Soochow University, Soochow
| | - Ming Zhou
- Guangzhou First People’s Hospital, Guangzhou
| | - Xiao-Jun Huang
- Peking University People’s Hospital, Peking University Institute of Hematology, Beijing,National Clinical Research Center for Hematologic Disease, Beijing,Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing,Peking-Tsinghua Center for Life Sciences, Beijing, China,X-J. Huang
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