期刊
PEDIATRIC BLOOD & CANCER
卷 69, 期 9, 页码 -出版社
WILEY
DOI: 10.1002/pbc.29845
关键词
children and adolescents; graft-versus-host disease; haploidentical hematopoietic stem cell transplant; serum ferritin; severe aplastic anemia; survival
资金
- National Key Research and Development Programof China [2017YFA0104500]
- Peking University Clinical Scientist Program [BMU2019LCKXJ003]
- National Natural Science Foundation of China [81670167, 82100227]
Elevated pretransplant serum ferritin levels are associated with increased incidences of higher-grade graft-versus-host disease after haploidentical hematopoietic stem cell transplant in children and adolescents with acquired severe aplastic anemia. However, it does not affect survival rates for these patients.
Haploidentical hematopoietic stem cell transplant (haplo-HSCT) provides an important alternative for children and adolescents with acquired severe aplastic anemia (SAA) lacking matched donors. To test whether pretransplant serum ferritin (SF) represents a candidate predictor for survival and a potential biomarker for graft-versus-host disease (GvHD) in pediatric haplo-HSCT, we retrospectively evaluated 147 eligible patients with SAA who underwent haplo-HSCT. The patients were divided into the low-SF group (< 1000 ng/mL) and the high-SF group (>= 1000 ng/mL). We found that SF >= 1000 ng/mL independently increased the risk of grade II-IV aGvHD (HR = 2.596; 95% CI, 1.304-5.167, P = 0.007) and grade III-IV aGvHD (HR = 3.350; 95% CI, 1.162-9.658, P = 0.025). Similar probabilities of transplant-related mortality at 100 days were observed in the two groups (6.19 +/- 2.45% vs 8.00 +/- 3.84%, P = 0.168). The two-year overall survival (85.29 +/- 3.89% vs 92.00% +/- 3.84%, P = 0.746) and failure-free survival (83.23% +/- 4.08% vs 83.37% +/- 6.27%, P = 0.915) were comparable. GvHD-/failure-free survival were 60.06 +/- 5.10% and 75.56 +/- 6.87%, respectively (P = 0.056). In conclusion, elevated pretransplant SF level is associated with higher incidences of grade II-IV aGvHD and grade III-IV aGvHD. However, it is not associated with worse survival after haplo-HSCT for children and adolescent patients with SAA.
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