Improved transplant outcomes with myeloablative conditioning for hemophagocytic lymphohistiocytosis in HLA-matched and mismatched donors: a national multicenter retrospective study

Yarden Greental Ness, Amir A. Kuperman, Jerry Stein, Joanne Yacobovich, Ehud Even-Or, Irina Zaidman, Aharon Gefen, Neta Nevo, Bernice Oberman, Amos Toren, Polina Stepensky, Bella Bielorai, Elad Jacoby

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

We report the results of national retrospective study of 45 children with hemophagocytic lymphohistiocytosis (HLH) who underwent allogeneic hematopoietic stem-cell transplantation (HSCT) in Israel between the years 2000–2018. Donors were either HLA-matched (n = 26), partially mismatched (n = 7), haploidentical (n = 8), or cord-blood (n = 4). Myeloablative conditioning (MAC) was used in 20 procedures, and reduced-intensity conditioning (RIC) in 25. Forty-two patients engrafted, two had primary graft failure (one successfully retransplanted), one died prior to engraftment, and two developed secondary graft failure. Of the eight patients who had mixed donor chimerism at day 30 (5–95%), five achieved stable mixed or full donor chimerism. The 5-year probabilities of overall survival and event-free survival (EFS) were 86% and 82%, respectively. Five-year EFS was lower for patients receiving RIC compared to MAC (72% vs. 100%, p = 0.018) and following alternative-donor transplant (68% vs. 92% for HLA-matched donors, p = 0.034), mostly due to increased transplant-related mortality (TRM). Thus, both HLA-matched and alternative donor transplant procedures may benefit form a myeloablative conditioning regimen.

Original languageEnglish
Pages (from-to)2088-2096
Number of pages9
JournalBone Marrow Transplantation
Volume56
Issue number9
DOIs
StatePublished - Sep 2021

Bibliographical note

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© 2021, The Author(s), under exclusive licence to Springer Nature Limited.

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