The recent improvements in the outcomes of severe aplastic anemia (SAA) patients who received allogeneic stem cell transplantation (SCT) from unrelated donors (URD) suggest the possibility of its alternative first-line treatment. To address this issue, results of adult SAA patients receiving allogeneic SCT were compared between the following three donor-type groups: 8/8–matched sibling (MSD; n = 153), 8/8 well-matched unrelated (WM-URD; n = 72), and 6–7/8 partially matched unrelated (PM-URD; n = 33). Proportion of patients who experienced immunosuppressive treatment failures was significantly higher in the URD groups than in the MSD group (P < 0.01). The incidences of graft failure and transplant-related mortality, and graft-vs.-host disease-free, failure-free survival rates of the MSD, WM-URD, and PM-URD groups were 14.6, 0, and 0% (P < 0.01); 6.1, 10.3, and 21.7% (P = 0.03); and 76.7, 55.5, and 51.5% (P < 0.01), respectively. The overall survival (OS) rate of the MSD group (93.9%) was higher than that of the PM-URD (78.3%; P < 0.01) group, but not to that of the WM-URD (86.2%; P = 0.18) group. Our study showed comparable OS between the MSD group and WM-URD group, which suggest that the URD-SCT can be used as a first-line treatment for adult SAA patients with WM-URD.

最近接受来自无关供者 (URD)​​ 的同种异体干细胞移植 (SCT) 的严重再生障碍性贫血 (SAA) 患者的结果的改善表明其替代一线治疗的可能性。为了解决这个问题，成人 SAA 患者接受同种异体 SCT 的结果在以下三个供体类型组之间进行了比较：8/8 匹配的兄弟姐妹（MSD；n  = 153），8/8 匹配良好的无关（WM-URD；n  = 72）和 6-7/8 部分匹配无关（PM-URD；n  = 33）。URD 组免疫抑制治疗失败的患者比例显着高于 MSD 组（P  < 0.01)。MSD、WM-URD 和 PM-URD 组的移植物失败率和移植相关死亡率以及移植物抗宿主病、无失败生存率分别为 14.6%、0% 和 0%（P  <  0.01); 6.1、10.3 和 21.7% ( P  =  0.03)；分别为76.7、55.5 和 51.5% ( P  <  0.01)。MSD组的总生存率（93.9%）高于PM-URD组（78.3%；P  < 0.01），但不高于WM-URD组（86.2%；P  =  0.18 ） ） 团体。我们的研究显示 MSD 组和 WM-URD 组的 OS 相当，这表明 URD-SCT 可用作 WM-URD 成人 SAA 患者的一线治疗。