Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Jan 30;13(1):e0191955.
doi: 10.1371/journal.pone.0191955. eCollection 2018.

Comparison of outcomes in hematological malignancies treated with haploidentical or HLA-identical sibling hematopoietic stem cell transplantation following myeloablative conditioning: A meta-analysis

Affiliations
Meta-Analysis

Comparison of outcomes in hematological malignancies treated with haploidentical or HLA-identical sibling hematopoietic stem cell transplantation following myeloablative conditioning: A meta-analysis

Dangui Chen et al. PLoS One. .

Abstract

Purpose: Haploidentical and human leukocyte antigen (HLA)-identical sibling hematopoietic stem transplantation are two main ways used in allogeneic hematopoietic stem cell transplantation (allo-HSCT). In recent years, remarkable progress has been made in haploidentical allo-HSCT (HID-SCT), and some institutions found HID-SCT had similar outcomes as HLA-identical sibling allo-HSCT (ISD-SCT). To clarify if HID-SCT has equal effects to ISD-SCT in hematologic malignancies, we performed this meta-analysis.

Methods: Relevant articles published prior to February 2017 were searched on PubMed. Two reviewers assessed the quality of the included studies and extracted data independently. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated for statistical analysis.

Results: Seven studies including 1919 patients were included. The rate of platelet engraftment is significantly lower after HID-SCT versus ISD-SCT while there is no difference in neutrophil engraftment (OR = 2.58, 95% CI = 1.70-3.93, P < 0.00001). The risk of acute graft-versus-host disease (GVHD) is significantly higher after HID-SCT versus ISD-SCT (OR = 1.88, 95% CI = 1.42-2.49, P < 0.00001), but the relapse rate is lower in HID-SCT group (OR = 0.70, 95% CI = 0.55-0.90, P = 0.005). The incidence rates of overall survival (OS) and disease-free-survival/leukemia-free survival/relapse-free survival (DFS/LFS/RFS) after ISD-SCT are all significantly superior to HID-SCT (OR = 1.32, 95% CI = 1.08-1.62, P = 0.006; OR = 1.25, 95% CI = 1.03-1.52, P = 0.02). There is no significant difference in transplantation related mortality (TRM) rate after HID-SCT and ISD-SCT.

Conclusion: After myeloablative conditioning, patients receiving ISD-SCT have a faster engraftment, lower acute GVHD and longer life expectancy compared to HID-SCT with GVHD prophylaxis (cyclosporine A, methotrexate, mycophenolate mofetil and antithymoglobulin; CsA + MTX + MMF + ATG). Currently, HID-SCT with GVHD prophylaxis (CsA + MTX + MMF + ATG) may not replace ISD-SCT when HLA-identical sibling donor available.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of selection of studies for inclusion in meta-analysis.
Fig 2
Fig 2. Forest plot of comparisons between HID-SCT and ISD-SCT: Neutrophil and platelet engraftment.
Fig 3
Fig 3. Forest plot of comparisons between HID-SCT and ISD-SCT: Acute GVHD and chronic GVHD.
Fig 4
Fig 4. Forest plot of comparisons between HID-SCT and ISD-SCT: Relapse and NRM/TRM.
Fig 5
Fig 5. Forest plot of comparisons between HID-SCT and ISD-SCT: DFS/LFS/RFS and OS.
Fig 6
Fig 6. Funnel plot of comparisons between HID-SCT and ISD-SCT: Chronic GVHD.

Similar articles

Cited by

References

    1. Ballen K, Gluckman E, Broxmeyer HE. Umbilical cord blood transplantation: the first 25 years and beyond. Blood.2013; 122(4):491–498. doi: 10.1182/blood-2013-02-453175 - DOI - PMC - PubMed
    1. Luznik L, O’Donnell PV, Symons HJ, Chen AR, Leffell MS, Zahurak M, et al. HLA haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant. 2008; 14(6): 641–650. doi: 10.1016/j.bbmt.2008.03.005 - DOI - PMC - PubMed
    1. Di BP, Santarone S, De AG, Picardi A, Cudillo L, Cerretti R, et al. Haploidentical, unmanipulated, G-CSF-primed bone marrow transplantation for patients with high-risk hematologic malignancies. Blood. 2013; 121(5):849–857. doi: 10.1182/blood-2012-08-453399 - DOI - PubMed
    1. Lai Y, Ma J, Schwarzenberger P, Li W, Cai Z, Zhou J, et al. Combination of CsA, MTX and Low–dose, short-course mycophenolate mofetil for GVHD prophylaxis. Bone Marrow Transplant.2009; 43(1):61–67. doi: 10.1038/bmt.2008.265 - DOI - PubMed
    1. Duggan P, Booth K, Chaudhry A, Stewart D, Ruether JD, Glück S, et al. Unrelated donor BMT recipients given pretransplant lowdose antithymocyte globulin have outcomes equivalent to matched sibling BMT: a matched pair analysis. Bone Marrow Transplant.2002; 30(10):681–686. doi: 10.1038/sj.bmt.1703674 - DOI - PubMed

Publication types