Comparable survival outcome between transplantation from haploidentical donor and matched related donor or unrelated donor for severe aplastic anemia patients aged 40 years and older: A retrospective multicenter cohort study.

Abstract

This retrospective multicenter cohort study aimed to compare the outcome of haploidentical hematopoietic stem cell transplantation (HID-HSCT) with matched sibling donor (MSD) and unrelated donor (URD) transplantation in severe aplastic anemia (SAA) patients 40years of age and older. With a median follow-up time of 17.6months, 85 consecutive patients were enrolled in the study, and the median patient age was 45years (40, 58). Thecumulative engraftment rates of neutrophil and platelet were 98.8 ± 0.0% and 92.9±0.1%. The cumulative incidences of Grade 2-4 acute graft-versus-host disease (aGvHD) and chronic graft-versus-host disease (cGvHD) at 3years were 14.1±0.1% and 17.3±0.2%. The 3-year estimated overall survival (OS) and failure-free survival (FFS) were 91.2±3.2% and 89.7±3.5%. In multivariate analysis, the only factor associated with inferior survival was an ECOG score ≥2. HID-HSCT was associated with a higher incidence of GvHD, but the difference of 3-year estimated OS between HID group and the other two cohorts was not significant (86.7±6.4% for HID vs 92.1%±4.4% for MSD and 100% for URD, P=.481). HID-HSCT might be a feasible alternative option for selected SAA patients aged 40years and older without a matched donor.