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Bulsufan decreases the incidence of mixed chimaerism in HLA-matched donor transplantation for severe aplastic anaemia

Bone Marrow Transplantation volume 57, pages 1204–1206 (2022)Cite this article

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Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a curative strategy for treating severe aplastic anaemia (SAA) [1]. Transplantation from HLA-matched donors has been recommended as a first-line choice for younger patients [2]. However, the optimal conditioning regimen has not been well determined. A recent study showed that fludarabine (Flu)/cyclophosphamide (Cy)/antithymocyte globulin (ATG) and Cy/ATG regimens offered the best survival following HLA-matched donor transplantation, but chimaerism status was not well evaluated [3].

Mixed chimaerism (MC) has been proven to be associated with secondary graft failure and inferior long-term survival outcomes [4, 5]. With conditioning consisting of 200 mg/kg Cy plus 10 mg/kg r-ATG, the incidences of MC have been reported to be 20.3% and 35.7% in matched sibling donor (MSD) or unrelated donor (URD) transplantation, respetively [5]. Thus, a more intensive conditioning regimen should be further explored to facilitate donor chimaerism. The role of Bu in promoting stable engraftment has been confirmed in numerous studies, especially in alternative donor transplantation [6,7,8]. Here, we designed a novel conditioning regimen by adding Bu (3.2 mg/kg) to decrease MC in HLA-matched donor transplantation for SAA, and we also conducted a comparison with a historic cohort.

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Fig. 1: EFS in the two cohorts.

Data availability

Individual participant data will not be shared. For original data, please contact huangxiaojun@bjmu.edu.cn.

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Acknowledgements

This work was partly supported by National Natural Science Foundation of China (Grant No. 82100227), Foundation for Innovative Research Groups of the National Natural Science Foundation of China (Grant No. 81621001), and The National Key Research and Development Program of China (No. 2017YFA0104500).

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  1. These authors contributed equally: Lan-Ping Xu, Zheng-Li Xu.

Authors and Affiliations

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

    Lan-Ping Xu, Zheng-Li Xu, Yuan-Yuan Zhang, Yi-Fei Cheng, Xiao-Dong Mo, Ting-Ting Han, Feng-Rong Wang, Chen-Hua Yan, Yu-Qian Sun, Yu-Hong Chen, Fei-Fei Tang, Wei Han, Yu Wang, Xiao-Hui Zhang, Kai-Yan Liu & Xiao-Jun Huang

  2. National Clinical Research Center for Hematologic Disease, Beijing, China

    Lan-Ping Xu, Zheng-Li Xu, Yuan-Yuan Zhang, Yi-Fei Cheng, Xiao-Dong Mo, Ting-Ting Han, Feng-Rong Wang, Chen-Hua Yan, Yu-Qian Sun, Yu-Hong Chen, Fei-Fei Tang, Wei Han, Yu Wang, Xiao-Hui Zhang, Kai-Yan Liu & Xiao-Jun Huang

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

    Xiao-Jun Huang

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

    Xiao-Jun Huang

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Contributions

XJH designed the research; LPX, ZLX and XJ analysed the data and wrote the paper; and all authors, provided patient data and gave final approval for the paper.

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Correspondence to Xiao-Jun Huang.

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Xu, LP., Xu, ZL., Zhang, YY. et al. Bulsufan decreases the incidence of mixed chimaerism in HLA-matched donor transplantation for severe aplastic anaemia. Bone Marrow Transplant 57, 1204–1206 (2022). https://doi.org/10.1038/s41409-022-01682-x

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