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Combination of haploidentical haematopoietic stem cell transplantation with an unrelated cord-blood unit in patients with severe aplastic anemia: a report of 146 cases
Bone Marrow Transplantation ( IF 4.674 ) Pub Date : 2020-03-26 , DOI: 10.1038/s41409-020-0874-9
Limin Liu; Yanming Zhang; Wenjing Jiao; Huifen Zhou; Qingyuan Wang; Huiying Qiu; Xiaowen Tang; Yue Han; Chengcheng Fu; Zhengming Jin; Suning Chen; Aining Sun; Miao Miao; Depei Wu

We analyzed the outcomes of 146 severe aplastic anemia (SAA) patients who received a combination of haploidentical haematopoietic stem cell transplantation (haplo-HSCT) and an unrelated cord-blood (UCB) unit between September 2011 and December 2017. One hundred and seventeen patients underwent transplantation as first-line therapy. Seven patients experienced early mortality, and among the evaluable 139 patients, one patient experienced primary graft failure (GF), while the other 138 patients achieved successful haploidentical donor engraftment; additionally, three patients experienced secondary GF. Six patients demonstrated delayed platelet recovery, and three patients demonstrated platelet GF. The median time for myeloid and platelet engraftment was 11 (range: 9–28) days and 15 (range: 9–330) days, respectively. With a median follow-up of 40 (range: 18–93) months, the cumulative incidences were 31.43% and 10.00% for grades II–IV and grades III–IV acute graft-versus-host disease (GVHD), respectively. The cumulative incidences of chronic GVHD (cGVHD) and moderate–severe cGVHD were 36.23% and 11.71%, respectively. There was no patient relapse. The probabilities of 4-year overall survival and GVHD-free, failure-free survival were 81.4 ± 3.3% and 69.2 ± 3.9%, respectively. These encouraging preliminary results indicated that haplo-HSCT combined with the infusion of UCB is a feasible choice for SAA patients without matched donors.
更新日期:2020-04-24

 

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