Haploidentical hematopoietic stem cell transplantation as a first-line treatment for paediatric severe aplastic anemia: a single-center research

MRD-HSCT is the first -line therapy for children with SAA, while it is not easy to find a compatible donor due to the Chinese one -child policy. IST has a high recurrence rate, a risk of clonal transformation. Thus, Haplo-HSCT, as a first -line treatment, has gradually attracted clinicians' attention. To evaluate the efficacy of Haplo-HSCT in children with SAA, we performed a retrospective study (2006.06-2021.01) of 210 patients with AA who received HSCT or IST in Beijing Children's Hospital. The OS and FFS rates were analyzed to evaluate the efficacy of Haplo-HSCT and IST. We found that from 2006 to 2021, 3- and 5 -year cumulative survival rates were both 85.3% in the first -line Haplo group, 98.1% and 96.8% in the first -line IST group, both 85.7% in the ATG group (P = 0.866), both 100% in the ATG + TPO group (P = 0.016), and 99.1% and 97.2% in the ATG + eltrombopag group (P = 0.056). 3- and 5 -year cumulative FFS rates were both 85.3% in the first -line Haplo-HSCT group and 67.5% and 66.2% in the first -line IST group (P = 0.033). Therefore, we believe that Haplo-HSCT can be a first -line treatment for paediatric SAA.