Acute Graft-versus-host Disease After Compatriots HLA Sibling-matched Versus Haploidentical Allogeneic Peripheral Blood Stem Cell Transplantation

ObjectiveTo compare occurrence characteristics of acute graft-versus-host disease aftercompatriots HLA sibling-matched versus haploidentical allogeneic peripheral bloodstem cell transplantation and to discuss the way to reduce the occurrence of acutegraft-versus-host disease and the clinical significance of haploidentical allogeneicperipheral blood stem cell transplantation.MethodsFifty-two patients undergoing allogeneic peripheral blood stem celltransplantation were retrospectively analyzed, including31cases of compatriots HLAsibling-matched cell transplantation and21cases of haploidentical allogeneicperipheral blood stem cell transplantation. Conditioning regimen was busulfan/cyclophosphamide for compatriots HLA sibling-matched patients,busulfan/cyclophosphamide and anti-thymocyte globulin for haploidentical patients.Short-termmethotrexate,cyclosporine A and mycophenolate mofetil was used for prevention ofgraft-versus-host disease.Results and conclusionAll patients successfully obtained persistent stem cell transplantation.48%patients (12/52) suffered from acute graft-versus-host disease, and23%patients(12/52) developed grade â…¢-â…£ acute graft-versus-host disease. The cumulativeincidence of acute graft-versus-host disease was39%(12/31) in the sibling-matched group and62%(12/21) in the sibling haploid-matched group (P>0.05). Thecumulative incidence of grade III-IV acute graft-versus-host disease was10%(3/31)in the sibling-matched group and42%(9/21) in the sibling haploid-matched group (P<0.05). Type distribution of acute graft-versus-host disease occurring at0-30days,31-60days,61-100days after cell transplantation showed no difference (P>0.05).The incidence of acute graft-versus-host disease occurring within30days aftertransplantation was higher than those within31-60and61-100days after celltransplantation. There were no differences in recurrence rate and2-year disease-freesurvival in the patients with or without acute graft-versus-host disease (P>0.05).Recurrence rate showed no difference between the sibling-matched group and siblinghaploid-matched group, but the2-year disease-free survival rate was higher in theformer group (P <0.05). Therefore, HLA haploidentical transplantation is a good wayto increase the source of donors for the treatment of haematological malignancies.