Influence of the degree of donor bone marrow hyperplasia on patient clinical outcomes after allogeneic hematopoietic stem cell transplantation

Sci China Life Sci. 2020 Jan;63(1):138-147. doi: 10.1007/s11427-018-9509-y. Epub 2019 Aug 13.

Abstract

This study evaluated the influence of the degree of donor bone marrow (BM) hyperplasia on patient clinical outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Twelve patients received allo-HSCT from hypoplastic BM donors between January 2010 and December 2017. Forty-eight patients whose donors demonstrated BM hyperplasia were selected using a propensity score matching method (1:4). Primary graft failure including poor graft function and graft rejection did not occur in two groups. In BM hypoplasia and hyperplasia groups, the cumulative incidence (CI) of neutrophil engraftment at day 28 (91.7% vs. 93.8%, P=0.75), platelet engraftment at day 150 (83.3% vs. 93.8%, P=0.48), the median time to myeloid engraftment (14 days vs. 14 days, P=0.85) and platelet engraftment (14 days vs. 14 days, P=0.85) were comparable. The 3-year progression-free survival, overall survival, CI of non-relapse mortality and relapse were 67.8% vs. 71.7% (P=0.98), 69.8% vs. 77.8% (P=0.69), 18.5% vs. 13.6% (P=0.66), and 10.2% vs. 10.4% (P=0.82), respectively. In multivariate analysis, donor BM hypoplasia did not affect patient clinical outcomes after allo-HSCT. If patients have no other suitable donor, a donor with BM hypoplasia can be used for patients receiving allo-HSCT if the donor Complete Blood Count and other examinations are normal.

Keywords: allogeneic hematopoietic stem cell transplantation; bone marrow aspirate; hyperplasic normal donor; hypoplasia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Marrow / surgery*
  • Child
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / mortality
  • Humans
  • Hyperplasia / etiology*
  • Incidence
  • Male
  • Middle Aged
  • Mortality
  • Retrospective Studies
  • Time Factors
  • Tissue Donors
  • Treatment Outcome