Haploidentical transplantation has been proposed as an effective treatment for severe aplastic anemia (SAA). The majority of patients have more than one HLA-haploidentical donor. Herein, we compared the outcomes between different donor-recipient relationships for optimal haploidentical donor selection in acquired SAA. We conducted a multicenter study based on a registered database of 392 patients with SAA treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) between 2006 and 2018. In total, 223 patients received grafts from father donors, 47 from mother donors, 91 from siblings, 29 from children, and 2 from collateral donors. Of the 381 patients who survived more than 28 days, 379 (99.5%) recipients were engrafted. The 2-year overall survival (OS) was 86.6 ± 2.5%, 87.1 ± 4.9%, 84.3 ± 3.9%, and 92.2 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.706). The 2-year failure-free survival (FFS) was 82.8 ± 2.7%, 86.7 ± 5.1%, 80.8 ± 4.2%, and 92.5 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.508). There was no difference in the incidence of either acute or chronic graft-versus-host disease (GVHD) among the different donor sources in multivariate analyses. There were also no differences in the OS or FFS among the different donor sources in the Cox regression analysis. However, OS was significantly better in the patients with a shorter history of aplastic anemia (< 12 months), better performance status (ECOG scores 0–1), or moderate graft mononuclear cell (MNC) counts (6–10 × 108/kg), and in female recipients with male donors. The FFS was also higher in patients with a shorter history of aplastic anemia (< 12 months) and better performance status (ECOG scores 0–1). Fathers, mothers, siblings, and children are all suitable haploidentical donors for patients with SAA.

中文翻译：

---

谁是获得性严重再生障碍性贫血的最佳单倍体供体？来自多中心研究的经验。

单倍体移植已被提议作为重度再生障碍性贫血（SAA）的有效治疗方法。大多数患者具有不止一个HLA单倍体供体。在本文中，我们比较了不同供者-受者关系之间的结果，以优化获得的SAA中的单倍性供体选择。在2006年至2018年之间，我们基于注册数据库对392名接受同种异体造血干细胞移植（allo-HSCT）治疗的SAA患者进行了多中心研究。总共有223名患者接受了父亲捐赠的移植物，47位母亲捐赠的移植物，91位来自捐赠者的移植物。兄弟姐妹，其中29人来自儿童，2人来自抵押捐助者。在381位存活超过28天的患者中，有379位（99.5％）接受了移植。2年总生存率（OS）为86.6±2.5％，87.1±4.9％，84.3±3.9％和92.2±5。父亲，母亲，兄弟姐妹和儿童移植物的接受者分别为1％（P = 0.706）。父亲，母亲，兄弟姐妹和儿童移植物的接受者的2年无失败生存率（FFS）分别为82.8±2.7％，86.7±5.1％，80.8±4.2％和92.5±5.1％（P = 0.508）。在多变量分析中，不同来源的急性或慢性移植物抗宿主病（GVHD）的发生率没有差异。在Cox回归分析中，不同供体来源之间的OS或FFS也没有差异。但是，在再生障碍性贫血病史较短（<12个月），表现状态较好（ECOG评分为0-1）或中度移植物单核细胞（MNC）计数（6-10×108 / kg）的患者中，OS显着改善。 ），以及女性捐赠者和男性捐赠者。再生障碍性贫血病史较短（<12个月）且表现良好（ECOG评分为0-1）的患者的FFS也较高。父亲，母亲，兄弟姐妹和孩子都是SAA患者合适的单倍体供体。