Comparative analysis of the efficacy and safety of haploidentical donor transplantation and HLA matched donor transplantation in the treatment of children with myelodysplastic syndrome
Comparative analysis of the efficacy and safety of haploidentical donor transplantation and HLA matched donor transplantation in the treatment of children with myelodysplastic syndrome
Objective To evaluate efficacy and safety of haploidentical donor transplantation as an alternative to allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children with myelodysplastic syndrome(MDS).Methods Clinical data of 22 children with MDS who received allo-HSCT from April 2013 to August 2022 in Children's Hospital of Suzhou University were collected.The patients were analyzed as follows:HLA matched donor(MSD+MUD)group and HLA-haploidentical related donor(HID)group.Results 22 cases were successfully engrafted with neutrophil and platelet.The median time of neutrophil and platelet engraftment were 11(10～12)and 11(9～17)days after transplantation in HID-HSCT group and MSD/MUD-HSCT group respectively.The median time of platelet engraftment were 11(8～16)and 12(7～28)days after transplantation respectively.Compared with HID group,the incidences of aGVHD(P=0.013)and Ⅱ～Ⅳ aGVHD(P=0.001)in MSD+MUD group were significantly different,but the incidences of Ⅲ～Ⅳ aGVHD,cGVHD,extensive cGVHD and the time to aGVHD were not significantly different.The incidence of preimplantation syndrome was 81.3％in the HID group,which was significantly higher than 17％in the MSD+MUD group(P=0.011).There were no significant difference in the incidence of CMV viremia,EBV viremia,hemorrhagic cystitis,pulmonary infection,and neurological complications between the MSD+MUD group and HID group.At the end of follow-up,the median follow-up time were 20.82(8.00～68.00)months in MSD+MUD group and 21.38(2.77～69.77)months in HID group.The 5-year OS rates were 100％and(72.7±17.7)％respectively.Conclusions There were no significant differences in cell engraftment,serious transplantation-related complications,immune reconstitution and long-term survival between haplo-HSCT and MSD/MUD-HSCT.Therefore,haplo-HSCT may be a suitable alternative for pediatric MDS patients who do not have a matched donor.
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