Haploidentical hematopoietic stem cell transplantation as a first-line treatment for paediatric severe aplastic anemia: a single-center research

Int J Med Sci. 2024 Apr 15;21(6):1027-1036. doi: 10.7150/ijms.94012. eCollection 2024.

Abstract

MRD-HSCT is the first-line therapy for children with SAA, while it is not easy to find a compatible donor due to the Chinese one-child policy. IST has a high recurrence rate, a risk of clonal transformation. Thus, Haplo-HSCT, as a first-line treatment, has gradually attracted clinicians' attention. To evaluate the efficacy of Haplo-HSCT in children with SAA, we performed a retrospective study (2006.06-2021.01) of 210 patients with AA who received HSCT or IST in Beijing Children's Hospital. The OS and FFS rates were analyzed to evaluate the efficacy of Haplo-HSCT and IST. We found that from 2006 to 2021, 3- and 5-year cumulative survival rates were both 85.3% in the first-line Haplo group, 98.1% and 96.8% in the first-line IST group, both 85.7% in the ATG group (P = 0.866), both 100% in the ATG + TPO group (P = 0.016), and 99.1% and 97.2% in the ATG + eltrombopag group (P = 0.056). 3- and 5-year cumulative FFS rates were both 85.3% in the first-line Haplo-HSCT group and 67.5% and 66.2% in the first-line IST group (P = 0.033). Therefore, we believe that Haplo-HSCT can be a first-line treatment for paediatric SAA.

Keywords: aplastic anemia; children; hematopoietic stem cell transplantation; immunosuppressive therapy.

MeSH terms

  • Adolescent
  • Anemia, Aplastic* / mortality
  • Anemia, Aplastic* / therapy
  • Benzoates / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Hydrazines / therapeutic use
  • Infant
  • Male
  • Pyrazoles / therapeutic use
  • Retrospective Studies
  • Transplantation, Haploidentical* / methods
  • Treatment Outcome

Substances

  • eltrombopag