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

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Fig. 1: EFS in the two cohorts.

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  1. Young NS. Aplastic Anemia. N Engl J Med. 2018;379:1643–56. e-pub ahead of print 2018/10/26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Georges GE, Doney K, Storb R. Severe aplastic anemia: allogeneic bone marrow transplantation as first-line treatment. Blood Adv. 2018;2:2020–8. e-pub ahead of print 2018/08/16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Bejanyan N, Kim S, Hebert KM, Kekre N, Abdel-Azim H, Ahmed I, et al. Choice of conditioning regimens for bone marrow transplantation in severe aplastic anemia. Blood Adv. 2019;3:3123–31. e-pub ahead of print 2019/10/28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kako S, Yamazaki H, Ohashi K, Ozawa Y, Ota S, Kanda Y, et al. Mixed Chimerism and Secondary Graft Failure in Allogeneic Hematopoietic Stem Cell Transplantation for Aplastic Anemia. Biol Blood Marrow Transpl. 2020;26:445–50. e-pub ahead of print 2019/10/17.

    Article  CAS  Google Scholar 

  5. Xu ZL, Cheng YF, Zhang YY, Mo XD, Han TT, Wang FR, et al. The incidence, clinical outcome, and protective factors of mixed chimerism following hematopoietic stem cell transplantation for severe aplastic anemia. Clin Transpl. 2021;35:e14160 e-pub ahead of print 2020/11/23.

    Article  CAS  Google Scholar 

  6. Dulley FL, Vigorito AC, Aranha FJ, Sturaro D, Ruiz MA, Saboya R, et al. Addition of low-dose busulfan to cyclophosphamide in aplastic anemia patients prior to allogeneic bone marrow transplantation to reduce rejection. Bone Marrow Transpl. 2004;33:9–13. e-pub ahead of print 2003/10/28.

    Article  CAS  Google Scholar 

  7. Apsel Winger B, Shukla P, Kharbanda S, Keizer RJ, Goswami S, Cowan MJ, et al. The Relationship Between Busulfan Exposure and Achievement of Sustained Donor Myeloid Chimerism in Patients with Non-Malignant Disorders. Transpl Cell Ther. 2021;27:258 e251–258 e256. e-pub ahead of print 2021/03/31.

    Article  CAS  Google Scholar 

  8. Qin X, Zhu YP, Luo CJ, Zhou M, Huang K, Chen C, et al. Optimizing conditioning regimen with low-dose irradiation or busulfan enables the outcome of transplantation from a 6-7/8 HLA-matched donor comparable to that from an 8/8 HLA-matched unrelated donor in severe aplastic anemia patients under 40 years. Ann Hematol. 2021;100:2363–73. e-pub ahead of print 2021/05/15.

    Article  CAS  PubMed  Google Scholar 

  9. Xu ZL, Xu LP, Zhang YY, Cheng YF, Mo XD, Wang FR, et al. Incidence and predictors of severe cardiotoxicity in patients with severe aplastic anaemia after haploidentical haematopoietic stem cell transplantation. Bone Marrow Transpl. 2019;54:1694–1700. e-pub ahead of print 2019/03/25.

    Article  Google Scholar 

  10. Bartelink IH, Lalmohamed A, van Reij EM, Dvorak CC, Savic RM, Zwaveling J, et al. Association of busulfan exposure with survival and toxicity after haemopoietic cell transplantation in children and young adults: a multicentre, retrospective cohort analysis. Lancet Haematol. 2016;3:e526–e536. e-pub ahead of print 2016/10/18.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Xu L-P, Xu Z-L, Wang S-Q, Wu D-P, Gao S-J, Yang J-M, et al. Long-term follow-up of haploidentical transplantation in relapsed/refractory severe aplastic anemia: a multicenter prospective study. Sci Bullet. 2022;

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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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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).

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