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Research Article: A comparative study of the impact of lineal relatives versus collateral relatives donor on prognosis in haplo-HSCT for aplastic anemia

Date Published: 2026-04-22

Abstract:
To investigate the impact of Lineal and Collateral donors on the prognosis of recipients in haplo-HSCT for AA among relatives. A retrospective analysis of data from AA patients who underwent haplo-HSCT at our center from January 2018 to January 2025. Patients were grouped based on the kinship between donors and recipients (Lineal vs. Collateral), and comparisons were made across key indicators, including engraftment, viral reactivation, GVHD, OS, and GRFS. The study included 190 AA patients who received haplo-HSCT. Based on donor type, they were divided into the Lineal group (134 patients) and the Collateral group (56 patients). The results showed that the 3-year OS (92.8% vs. 75.3%, P = 0.004) and 3-year GRFS (78.5% vs. 64.9%, P = 0.062) were relatively higher in the Collateral group compared to the Lineal group. Further analysis revealed that younger donors (age ? 40 years) and younger patients (age ? 40 years) contributed significantly to improved outcomes in the Collateral group, with both 3-year OS and GRFS being significantly better than in the Lineal group. The study suggests that Collateral donors represent a viable and effective option, particularly in the absence of Lineal donors. The age of the donor and recipient is a critical factor influencing transplantation outcomes, with younger donors and patients potentially enhancing therapeutic efficacy.

Introduction:
Aplastic anemia (AA) is a syndrome of bone marrow failure caused by multiple etiologies, characterized clinically by marrow hypoplasia, pancytopenia, and symptoms such as anemia, bleeding, and infection ( 1 , 2 ). Based on disease severity, AA is classified into non-severe (NSAA), severe (SAA), and very severe (VSAA). SAA and VSAA are life-threatening conditions associated with poor prognosis in the absence of timely and effective intervention. For younger patients with a human leukocyte antigen (HLA)-matched…

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