A Comparative Study On The Effect Of Allogeneic Hematopoietic Stem Cell Transplantation In Children With Thalassemia Of Different Ages

Objective: To compare the effect of Allogeneic hematopoietic stem cell transplantation(Allo-HSCT)in patients with Thalassemia who received HSCT at different ages in our department,These results will be used as the basis for the selection of the time of receiving stem cell transplantation in children with Thalassemia.Methods: To review the clinical data of 67 children with thalassemia who underwent allogeneic hematopoietic stem cell transplantation admitted to the hematology department of Zhongshan hospital affiliated to xiamen university from January 2012 to December 2019,and divided into 2 ～ 5 years old and 6 ～ 12 years old two groups.Use SPSS software to compare the differences between the two groups in hematopoietic reconstitution,implantation,fungal and bacterial infection,EBV,CMV,OS,TFS,acute and chronic GVHD,hemorrhagic cystitis and oral mucositis.Results: A total of 67 pediatric patients are included in the study.The deadline of follow-up is January 30,2020.There is no lack of follow-up data.The median follow-up time period is 24 months(37 days ～ 94 months).The median transplantation age of all pediatric patients is 4 years old(2 ～ 12 years old),and the average transplantation age is(4.93±2.27 years old).The overall survival is 95.52%with 5 cases dead.The transplantation related mortalityis 7.46%.OS and TFS are93.02%,91.67% and 88.37% and 87.50% respectively in the low-age group and the high-age group of 5 years.There is no significant difference between the two groups in hematopoiesis reconstruction,implant failure,fungal,bacterial infection,OS and TFS as P > 0.05.There is significant difference in hemorrhagic cystitis and severe oral mucositis between the two groups as P<0.05.Conclusion:(1)Allogeneic stem cell transplantation is the only way to cure thalassemia.The long-term survival rate can reach more than 90%.(2)There is no significant statistical difference in the success rate and overall survival rate of Allogeneic stem cell transplantation in children under 12 years old.(3)The incidence of a GVHD,c GVHD and severe oral mucositis in the 2 ～ 5 year old group is significantly lower than that in the 6 ～ 12 year old group with statistical differences.(4)In the 2 ～ 5 year old group,there are fewer complications of lighter degree,and higher quality of life,suggesting that age may be an independent factor affecting the quality of life of children with thalassemia after transplantation.