Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Turk J Med Sci. 2023 Feb;53(1):352-359. doi: 10.55730/1300-0144.5591. Epub 2023 Feb 22.
Since well-designed prospective comparative trials are lacking, haploidentical hematopoietic stem cell transplantations approach should be based on the expertise of a particular center. In this study, we aimed to report the results and outcomes of patients who underwent haploidentical hematopoietic stem cell transplantation.
: Thirty-nine patients who underwent transplantation in our clinic between 2015 and 2022 were retrospectively analyzed. Primary end point of this study is to find out the survival rates of the patients.
The overall survival of patients was 29.9 ± 4.9 months. The disease-free survival of the patients was 37.8 ± 5.7 months. The 3-year overall survival rate of the patients was %50 and the 3-year disease-free survival rate of the patients was %53. Nineteen patients were nonsurvivors among a total of 39 patients. Busulfan-fludarabine-thiotepa was the most frequently used conditioning regimen for transplantation. Busulfan-fludarabin-antithymocyte globulin regimen is the second preferred conditioning regimen. Cyclosporine- cyclophosphamide-mycophenolate mofetil was the most widely used graft-versus-host disease prophylaxis regimen. Sixteen patients had graft-versus-host disease, 28% of the patients had acute graft-versus-host disease, and 13% had chronic graft-versus-host disease. Gastrointestinal system consists of the most involved organs in graft-versus-host disease since 15% of the patients had gastrointestinal graft-versus-host disease. First-degree relatives (parent/child) were the most frequent donor source for haploidentical hematopoietic stem cell transplantation. Sepsis was the most frequent reason of death among transplant patients.
In our center, we prefer to use high dose posttransplantation cyclophosphamide after haploidentical hematopoietic stem cell transplantation for graft-versus-host disease prophylaxis. With this approach, our center's overall survival and disease-free survival rates are comparable and compatible with the literature findings.
由于缺乏精心设计的前瞻性对照试验，因此同种异体造血干细胞移植方法应基于特定中心的专业知识。在本研究中，我们旨在报告在我们的诊所接受半相合造血干细胞移植的患者的结果和结局。
回顾性分析了 2015 年至 2022 年期间在我们的诊所接受移植的 39 名患者。本研究的主要终点是找出患者的生存率。
患者的总体生存率为 29.9±4.9 个月。患者的无病生存率为 37.8±5.7 个月。患者的 3 年总生存率为 50%，3 年无病生存率为 53%。在总共 39 名患者中，有 19 名患者死亡。在移植中最常使用的预处理方案是白消安-氟达拉滨-噻替哌。白消安-氟达拉滨-抗胸腺细胞球蛋白方案是第二首选的预处理方案。环孢菌素-环磷酰胺-霉酚酸酯是最广泛使用的移植物抗宿主病预防方案。16 名患者发生移植物抗宿主病，28%的患者发生急性移植物抗宿主病，13%的患者发生慢性移植物抗宿主病。胃肠道系统是移植物抗宿主病最常涉及的器官，因为 15%的患者发生胃肠道移植物抗宿主病。在半相合造血干细胞移植中，一级亲属（父母/子女）是最常见的供体来源。感染是移植患者死亡的最常见原因。
在我们的中心，我们倾向于在半相合造血干细胞移植后使用高剂量移植后环磷酰胺预防移植物抗宿主病。通过这种方法，我们中心的总体生存率和无病生存率与文献发现相当且一致。
