The impact of pretransplant serum ferritin on haploidentical hematopoietic stem cell transplant for acquired severe aplastic anemia in children and adolescents. Issue 9 (30th June 2022) - Lin, Fan
Abstract: Haploidentical hematopoietic stem cell transplant (haplo‐HSCT) provides an important alternative for children and adolescents with acquired severe aplastic anemia (SAA) lacking matched donors. To test whether pretransplant serum ferritin (SF) represents a candidate predictor for survival and a potential biomarker for graft‐versus‐host disease (GvHD) in pediatric haplo‐HSCT, we retrospectively evaluated 147 eligible patients with SAA who underwent haplo‐HSCT. The patients were divided into the low‐SF group (< 1000 ng/mL) and the high‐SF group (≥ 1000 ng/mL). We found that SF ≥1000 ng/mL independently increased the risk of grade II‐IV aGvHD (HR = 2.596; 95% CI, 1.304‐5.167, P = 0.007) and grade III‐IV aGvHD (HR = 3.350; 95% CI, 1.162‐9.658, P = 0.025). Similar probabilities of transplant‐related mortality at 100 days were observed in the two groups (6.19 ± 2.45% vs 8.00 ± 3.84%, P = 0.168). The two‐year overall survival (85.29 ± 3.89% vs 92.00% ± 3.84%, P = 0.746) and failure‐free survival (83.23% ± 4.08% vs 83.37% ± 6.27%, P = 0.915) were comparable. GvHD‐/failure‐free survival were 60.06 ± 5.10% and 75.56 ± 6.87%, respectively ( P = 0.056). In conclusion, elevated pretransplant SF level is associated with higher incidences of grade II‐IV aGvHD and grade III‐IV aGvHD. However, it is not associated with worse survival after haplo‐HSCT for children and adolescent patients with SAA.