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Causes of mortality after haploidentical hematopoietic stem cell transplantation and the comparison with HLA-identical sibling hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 51, pages 391–397 (2016)Cite this article

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Abstract

This study was performed to investigate incidence, causes and factors influencing mortality after haploidentical hematopoietic stem cell transplantation (HSCT) and to compare differences between haploidentical HSCT and HLA-identical sibling HSCT. From January 2000 to June 2011, 1411 patients with acute leukemia or myelodysplastic syndrome were included in this study. Of these patients, 571 received HLA-identical sibling HSCT and 840 received haploidentical HSCT. The cumulative incidence of overall mortality and transplant-related mortality (TRM) after haploidentical HSCT was higher than those after HLA-identical sibling HSCT (38.7% vs 33.3%, P=0.012 and 27.5% vs 19.9%, P=0.002), but the incidence of relapse-related mortality (RRM) did not differ between the two groups (15.6% vs 16.7%, P=0.943). A multivariate analysis suggested that high-risk disease status and haploidentical HSCT correlated with a higher incidence of overall mortality (P<0.0001, hazard ratio=1.911 and P=0.019, hazard ratio=1.249); in addition, in haploidentical HSCT, only high-risk disease status correlated with a higher incidence of overall mortality (P<0.0001, hazard ratio=1.845). Our study suggested that haploidentical HSCT provided a higher incidence of overall mortality and TRM but the same incidence of RRM compared with HLA-identical sibling HSCT. Therefore, HLA-identical sibling HSCT remains the first choice, but haploidentical HSCT is available for patients without an HLA-identical sibling donor.

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Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, People’s Republic of China

    C-H Yan, L-P Xu, F-r Wang, H Chen, W Han, Yu Wang, J-z Wang, K-Y Liu & X-J Huang

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X-J Huang participated in the designation of the research; C-H Yan participated in the writing of the manuscript and data analysis; all others participated in providing patient data.

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Yan, CH., Xu, LP., Wang, Fr. et al. Causes of mortality after haploidentical hematopoietic stem cell transplantation and the comparison with HLA-identical sibling hematopoietic stem cell transplantation. Bone Marrow Transplant 51, 391–397 (2016). https://doi.org/10.1038/bmt.2015.306

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