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Comparable clinical outcomes of haploidentical hematopoietic stem cell transplantation in patients with hepatitis-associated aplastic anemia and non-hepatitis-associated aplastic anemia

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Abstract

Hepatitis-associated aplastic anemia (HAAA), a rare subtype of aplastic anemia (AA), is defined as bone marrow failure occurring after acute hepatitis. Severe HAAA requires immunosuppressive therapy (IST) or hematopoietic stem cell transplantation (HSCT) as lifesaving treatment. The outcomes of HAAA patients who underwent haploidentical hematopoietic stem cell transplantation (haplo-HSCT) have not been systematically evaluated. We retrospectively compared the characteristics of 15 patients with HAAA and 60 non-hepatitis-associated aplastic anemia (non-HAAA) patients, all 75 of whom underwent haplo-HSCT in our hospital between January 2006 and October 2021. The median ages of the patients were 18 years old (range, 3–36) for HAAA patients and 13 years (range, 2–45) for non-HAAA patients (p = 0.693). The median time for neutrophil engraftment was 14 days (range, 11–22) in the HAAA group and 12 days (range, 10–21) in the non-HAAA group (p = 0.363). At the time of analysis, 15 HAAA patients and 58 non-HAAA patients were alive, and their median follow-up times were 37 (range, 3–87) months and 31 (range, 2–110) months (p = 0.347), respectively. There were no significant differences in the three-year overall survival (OS) rates (100% vs. 96.7 ± 0.33%, P = 0.638) or liver event-free survival (LEFS) (80.0 ± 0.17% vs. 76.7 ± 0.19%, P = 0.747) between the two groups. Despite the small number of HAAA patients due to the rarity of the disease, these results, such as the similar incidence rates of 3-year OS and fewer liver events than expected, suggest that haplo-HSCT is a feasible treatment for HAAA a when there are no human leukocyte antigen (HLA)-matched donors available and has a low risk of transplant-related mortality and complications.

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Acknowledgements

We extend our gratitude to all colleagues who contributed to this paper.

Funding

This work was supported by the National Natural Science Foundation of China (82100227), the Foundation for Innovative Research Groups of the National Natural Science Foundation of China (81621001), and the Key Program of National Natural Science Foundation of China (81930004).

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Authors and Affiliations

  1. National Clinical Research Centre for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplant, Peking University People’s Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, 100044, Beijing, China

    Xiaodi Ma, Yangyang Zuo, Zhengli Xu, Yuanyuan Zhang, Yifei Cheng, Tingting Han, Pan Suo, Yuqian Sun, Feifei Tang, Fengrong Wang, Chenhua Yan, Yuhong Chen, Yu Wang, Xiaohui Zhang, Kaiyan Liu, Xiaojun Huang & Lanping Xu

  2. Peking-Tsinghua Centre for Life Sciences, Beijing, China

    Xiaojun Huang

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  1. Xiaodi Ma
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Contributions

Prof. L. P Xu and Prof. X. J Huang designed the study. X.D. Ma and Y.Y. Zuo collected and analyzed the data. All authors reviewed and approved the manuscript.

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Correspondence to Lanping Xu.

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Xiaodi Ma and Yangyang Zuo contributed equally to this work and share first authorship.

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Ma, X., Zuo, Y., Xu, Z. et al. Comparable clinical outcomes of haploidentical hematopoietic stem cell transplantation in patients with hepatitis-associated aplastic anemia and non-hepatitis-associated aplastic anemia. Ann Hematol 101, 1815–1823 (2022). https://doi.org/10.1007/s00277-022-04885-w

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