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Unmanipulated haploidentical transplantation conditioning with busulfan, cyclophosphamide and anti-thymoglobulin for adult severe aplastic anaemia

Bone Marrow Transplantation volume 53, pages 188–192 (2018)Cite this article

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Abstract

We conducted a retrospective analysis to evaluate outcomes of haploidentical transplantation in adult severe aplastic anaemia (SAA) patients. Fifty-one adults received haploidentical transplantation between May 2011 and December 2016. Patients were administered busulfan (Bu), cyclophosphamide (Cy) and anti-thymoglobulin (ATG) as conditioning regimens, followed by bone marrow and peripheral blood transplantation. The patients’ median age was 25 years. Forty-nine patients survived for more than 28 days and all achieved donor myeloid engraftment. The median time for myeloid engraftment and platelet recovery was 13 days (range, 10–21) and 17.5 (range, 7–101) days. The cumulative incidence (CI) of grade II–IV and III–IV acute GvHD) was 20.00±0.33% and 6.00±0.12%, respectively. The incidence of chronic GvHD was 14.00±0.36% and 25.90±0.71%, and that of moderate-severe chronic GvHD was 2.51±0.06% and 6.92±0.25% at 1 and 3 years, respectively. The 3-year estimated overall survival and failure-free survival were both 83.5±5.4% with a median follow-up of 21.1 months. Multivariate analysis showed hematopoietic cell transplantation-specific comorbidity index (HCT-CI) score of ⩾3 was significantly associated with worse outcome. Haploidentical transplantation conditioning including Bu/Cy/ATG was a safe and effective strategy for adult SAA patients, and HCT-CI might be an outcome predictor in these patients.

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Acknowledgements

This work was partly supported by Collaborative Innovation Centre of Haematology China, National Natural Science Foundation of China (Grant No. 81230013 and 81370666) and Beijing Municipal Science & Technology Commission (No. Z141100000214011 and Z151100001615020). We thank all colleagues for participating in this research.

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  1. L-P Xu and Z-L Xu: These authors contributed equally to this work.

Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, China

    L-P Xu, Z-L Xu, F-R Wang, X-D Mo, T-T Han, W Han, Y-H Chen, Y-Y Zhang, J-Z Wang, Y Wang, C-H Yan, Y-Q Sun, F-F Tang, X-H Zhang & X-J Huang

  2. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China

    X-J Huang

  3. Peking-Tsinghua Center for Life Sciences, Beijing, China

    X-J Huang

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Xu, LP., Xu, ZL., Wang, FR. et al. Unmanipulated haploidentical transplantation conditioning with busulfan, cyclophosphamide and anti-thymoglobulin for adult severe aplastic anaemia. Bone Marrow Transplant 53, 188–192 (2018). https://doi.org/10.1038/bmt.2017.237

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