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Stem cell transplantation

Haploidentical transplant for myelodysplastic syndrome: registry-based comparison with identical sibling transplant

Leukemia volume 30, pages 2055–2063 (2016)Cite this article

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Abstract

Encouraging results from a small sample of patients with myelodysplastic syndrome (MDS) undergoing haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT) must be extended. Furthermore, an algorithm derived from a comparison of the outcomes of HID and identical-sibling donor (ISD) HSCT must be established. Therefore, the outcomes of 454 MDS patients who underwent HSCT from HIDs (n=226) or ISDs (n=228) between 2003 and 2013 that were reported to the Chinese Bone Marrow Transplantation Registry were analyzed. Among the 3/6 HID (n=136), 4–5/6 HID (n=90) and ISD patient groups, the 4-year adjusted cumulative incidences of non-relapse mortality were 34, 29 and 16%, respectively (overall P=0.004), and of relapse were 6, 7 and 10%, respectively (overall P=0.36). The 4-year adjusted probabilities of overall survival were 58, 63 and 73%, respectively (overall P=0.07), and of relapse-free-survival were 58, 63 and 71%, respectively (overall P=0.14); pairwise comparison showed that the difference was only statistically significant in the 3/6 HID vs ISD pair. The data suggest that ISDs remain the best donor source for MDS patients while HIDs (perhaps 4–5/6 HID in particular) could be a valid alternative when an ISD is not available; human leukocyte antigen disparity had no effect on survival among the HID patients.

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Acknowledgements

This work was partly supported by Collaborative Innovation Center of Hematology China, The Key Program of National Natural Science Foundation of China (Grant No. 81230013), National Natural Science Foundation of China (Grant No. 81400143) and Beijing Municipal Science & Technology Commission (No. Z121107002612035, Z141100000214011 and Z151100001615020).

Author contributions

X-JH designed the research; YW and X-JH analyzed the data and wrote the manuscript; and all authors provided patient data and gave final approval for the manuscript.

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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, China

    Y Wang, L-P Xu & X-J Huang

  2. Air Force General Hospital, PLA, Beijing, China

    H-X Wang

  3. Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China

    Y-R Lai

  4. Anhui Provincial Hospital, Hefei, Anhui, China

    Z-M Sun

  5. The first affiliated hospital of Soochow University, Suzhou, Jiangsu, China

    D-P Wu

  6. Department of Hematology, The First Affiliated Hospital of Xinjiang Medical University, Wulumuqi, Xinjiang, China

    M Jiang

  7. PLA General Hospital, Beijing, China

    D-H Liu

  8. The Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu, China

    K-L Xu

  9. Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China

    Q-F Liu

  10. The first Affiliated Hospital of Chongqing Medical University, Chongqing, China

    L Liu

  11. Aero Center Space Hospital, Beijing, China

    J-B Wang

  12. The Affiliated Hospital of North China University Science and Technology, Tangshan, Hebei, China

    F Gao

  13. Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China

    J Ou-Yang

  14. The First Affiliated Hospital of Jilin University, Changchun, Jilin, China

    S-J Gao

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

    X-J Huang

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Wang, Y., Wang, HX., Lai, YR. et al. Haploidentical transplant for myelodysplastic syndrome: registry-based comparison with identical sibling transplant. Leukemia 30, 2055–2063 (2016). https://doi.org/10.1038/leu.2016.110

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