Article
Author: Li, Xin ; Zhang, Jian-Ping ; Zhang, Yu-Ping ; Xu, Ya-Jing ; Wu, Tong ; Wang, Chun ; Xu, Lan-Ping ; Zhang, Xi ; He, Peng-Cheng ; Zhang, Xue-Jun ; Ran, Xue-Hong ; Liu, Dai-Hong ; Huang, Jin-Xiong ; Xu, Zheng-Li ; Wang, Shun-Qing ; Su, Nan ; Lu, Pei-Hua ; Liu, Li ; Bai, Guan-Chen ; Zhou, Fang ; Chen, Jie-Ping ; Zhao, Xin ; Ye, Bao-Dong ; Yang, Hai-Ping ; Sun, Zi-Min ; Guo, Zi-Wen ; Su, Guo-Hong ; Zhou, Ming ; Yi, Hai ; Fan, Sheng-Jin ; Zhang, Yan-Ming ; Jiang, Er-Lie ; Song, Xian-Min ; Huang, Xiao-Jun
Our study includes 278 patients aged between 40 and 50 years from 29 centers who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) from matched sibling donors (MSDs) (n = 106) and haploidentical donors (HIDs) (n = 172) over the last decade. Univariate analysis revealed that HID recipients was associated with more serious disease severity, a delayed allo-HSCT 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 observed comparable overall survival (OS) (P = 0.14); failure free survival (FFS) (P = 0.23); GVHD-free/relapse-free survival (GRFS) (P = 0.26) between matched HID and MSD recipients. In conclusion, our data indicates that allo-HSCT from an HID could be considered for SAA patients between 40 and 50 years old who do not have an MSD.