<p>Objective: To evaluate the efficacy and prognostic factors of haploidentical haematopoietic stem cell transplantation (haplo-HSCT) for paroxysmal nocturnal haemoglobinuria (PNH). Methods: We retrospectively analyzed 36 PNH patients (2 classic PNH, 34 AA-PNH syndrome) undergoing haplo-HSCT (G-CSF/ATG-based protocol) from June 2013 to December 2024, with BU/CY/ATG (n = 28) or BU/CYlow/FLU/ATG (n = 8) conditioning and uniform GVHD prophylaxis. Results: The overall myeloid engraftment rate was 100% (median + 12 d) and platelet engraftment rate 95.5% (median + 13 d). Competing risk analysis showed 42.7% acute GVHD (26.7% grade II–IV, 5.3% grade III–IV); 27.3% chronic GVHD (15.2% mild, 12.1% moderate-severe) among 33 evaluable patients. With a median follow-up of 57 months, the 5-year overall survival rate was 88.6 ± 5.4%. All 32 monitored patients achieved PNH clone clearance (median 3 months), 33 had normalized blood counts, and 3 died of infection, organ hemorrhage or pulmonary embolism. Conclusions: Haplo-HSCT yields favorable outcomes and is a curative therapy for PNH, serving as a valuable option for severe bone marrow failure patients, with G-CSF/ATG-based haplo-HSCT as a promising alternative strategy.</p>

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Haploidentical allogeneic haematopoietic stem cell transplantation for paroxysmal nocturnal haemoglobinuria: a retrospective analysis

  • Jing-Yi Bi,
  • Yuan-Yuan Zhang,
  • Hai-Xia Fu,
  • Yun He,
  • Ting-Ting Han,
  • Yao Chen,
  • Zhi-Dong Wang,
  • Jun Kong,
  • Jing-Zhi Wang,
  • Xiao-Dong Mo,
  • Yu-Qian Sun,
  • Yi-Fei Cheng,
  • Yu-Hong Chen,
  • Yu Wang,
  • Xiao-Hui Zhang,
  • Xiao-Jun Huang,
  • Zheng-Li Xu,
  • Lan-Ping Xu

摘要

Objective: To evaluate the efficacy and prognostic factors of haploidentical haematopoietic stem cell transplantation (haplo-HSCT) for paroxysmal nocturnal haemoglobinuria (PNH). Methods: We retrospectively analyzed 36 PNH patients (2 classic PNH, 34 AA-PNH syndrome) undergoing haplo-HSCT (G-CSF/ATG-based protocol) from June 2013 to December 2024, with BU/CY/ATG (n = 28) or BU/CYlow/FLU/ATG (n = 8) conditioning and uniform GVHD prophylaxis. Results: The overall myeloid engraftment rate was 100% (median + 12 d) and platelet engraftment rate 95.5% (median + 13 d). Competing risk analysis showed 42.7% acute GVHD (26.7% grade II–IV, 5.3% grade III–IV); 27.3% chronic GVHD (15.2% mild, 12.1% moderate-severe) among 33 evaluable patients. With a median follow-up of 57 months, the 5-year overall survival rate was 88.6 ± 5.4%. All 32 monitored patients achieved PNH clone clearance (median 3 months), 33 had normalized blood counts, and 3 died of infection, organ hemorrhage or pulmonary embolism. Conclusions: Haplo-HSCT yields favorable outcomes and is a curative therapy for PNH, serving as a valuable option for severe bone marrow failure patients, with G-CSF/ATG-based haplo-HSCT as a promising alternative strategy.