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Comparison of clinical outcomes between peripheral blood stem cells and peripheral blood stem cells plus bone marrow in myelodysplastic syndrome patients with haploidentical transplantation

Bone Marrow Transplantation volume 58, pages 142–151 (2023)Cite this article

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Abstract

The comparison of haploidentical G-CSF-mobilized peripheral blood and bone marrow transplantation (HBMT) for patients with myelodysplastic syndrome (MDS) and haploidentical G-CSF-primed peripheral blood stem cell transplantation (HPBSCT) remains unclear. We performed a retrospective analysis using a propensity score method on 140 MDS patients who received HPBSCT (n = 46) or HBMT (n = 94) with BU/CY as a conditioning regimen prior to transplantation at our center between June 2016 and June 2021. HBMT recipients were associated with a reduced incidence of grade III-IV acute GVHD (17.22% vs. 30.57%, p = 0.019) within 100 days, reduced 2-year transplant-related mortality (TRM) (14.29% vs. 28.94%, p = 0.045) and superior 2-year overall survival (OS) (81.6% vs. 66.0%, p = 0.027), progression-free survival (PFS) (80.9% vs. 61.2%, p = 0.015), and GVHD relapse-free survival (GRFS) (64.6% vs. 53.3%, p = 0.062) compared with HPBSCT, but 2-year relapse incidence (RI) (5.96% vs. 9.39%, p = 0.445) was not affected. Multivariate analysis revealed that a GPB/GBM mixture was the independent factor for a reduced incidence of grade III-IV acute GVHD (p = 0.018) and TRM (p = 0.048), improved OS (p = 0.029), PFS (p = 0.019) and GRFS (p = 0.072). Collectively, the use of a GPB/GBM mixture as stem cell grafts for haplo-HSCT in patients with MDS appears to be an optimal choice.

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Fig. 1: Mutations in patients detected by next-generation sequencing.
Fig. 2: Survival outcomes for 140 MDS patients undergoing haplo-HSCT according to graft source.
Fig. 3: The forest plot of the subgroup analysis of the patients.
Fig. 4: Monitoring of chimerism and analysis of lymphocyte subsets after transplantation between two cohorts.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This work was supported in part by grants from the National Natural Science Foundation of China (81730003, 81870120, 82070187, 82020108003, 82000140), the Social Development Project of Jiangsu Province (BE2019655), the Jiangsu Province Key R&D Program (BE2019798), the Suzhou Science Project (SKY2021104), the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), the National Key Research and Development Program (2019YFC0840604), and the Natural Science Foundation of Jiangsu Province (BK20200197).

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  1. These authors contributed equally: Mengqian Chu, Shuhong Hu, Yifan Shen.

Authors and Affiliations

  1. Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, PR China

    Mengqian Chu, Shuhong Hu, Yifan Shen, Danya Shen, Yuchen Zhan, Yi Fan, Jia Chen, Xiaowen Tang, Depei Wu & Yang Xu

  2. Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China

    Shuhong Hu, Yi Fan, Jia Chen, Depei Wu & Yang Xu

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Depei Wu and Yang Xu were responsible for the conception of the study and paper revision. Mengqian Chu, Shuhong Hu, and Yifan Shen contributed to performing the research study, analyzing data and writing the manuscript. Danya Shen and Yuchen Zhan helped complete the research study and perform data analysis. Yi Fan, Jia Chen and Xiaowen Tang contributed to the data analysis, manuscript writing and study supervision.

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Chu, M., Hu, S., Shen, Y. et al. Comparison of clinical outcomes between peripheral blood stem cells and peripheral blood stem cells plus bone marrow in myelodysplastic syndrome patients with haploidentical transplantation. Bone Marrow Transplant 58, 142–151 (2023). https://doi.org/10.1038/s41409-022-01862-9

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