{
  "abstract": "Background: Severe aplastic anemia (SAA) is a fatal bone marrow failure disorder. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the definitive curative treatment for SAA. This study evaluated the prognosis of patients with severe aplastic anemia (SAA) receiving different allo-HSCT regimens.\n\nMethods: A retrospective analysis was performed on 62 patients with aplastic anemia who underwent allo-HSCT between January 2015 and August 2024. The cohort comprised 32 males and 30 females, with a median age of 12 years (range, 1.5–44 years) at transplantation; 28 patients were ≥14 years old and 34 were <14 years. Forty-eight patients were diagnosed with severe AA (SAA) and 14 with very severe AA (VSAA). Twenty-two patients underwent HLA-matched sibling donor transplantation(MSD-HSCT), and 40 underwent HLA-haploidentical sibling donor transplantation(Haplo-HSCT).Three conditioning regimens were administered: cyclophosphamide plus anti-thymocyte globulin (CY+ATG, CA, n=11), fludarabine + cyclophosphamide + ATG (Flu+CY+ATG, FCA, n=26), and fludarabine + melphalan + ATG (Flu+Mel+ATG, FMA, n=25).\n\nResults: The median follow-up duration of the 62 patients was 38 months (range: 0–136 months). Twelve deaths occurred during follow-up. Post-transplant complications included post-transplant lymphoproliferative disorder (PTLD) in 3 patients (4.84%), acute graft-versus-host disease (aGVHD) in 7 patients (11.29%), chronic GVHD (cGVHD) in 2 patients (3.23%), Epstein-Barr virus (EBV) viremia in 10 patients (16.13%), and invasive fungal disease in 1 patient (1.62%). The median time to neutrophil engraftment was 13 days (evaluable in 55 patients). Kaplan-Meier survival analysis revealed no statistically significant difference in 5-year overall survival (OS) between MSD-HSCT and Haplo-HSCT groups (P = 0.582). The 5-year OS rate was 76.8% for the MSD-HSCT (n=22) and 80.6% for the Haplo-HSCT group (n=40). No significant intergroup difference in 5-year OS was detected across the three conditioning regimens (P = 0.85); the 5-year OS rates of the CA, FCA, and FMA groups were 81.6%, 76.8%, and 84.0%, respectively.\n\nConclusions: (1)MSD-HSCT and Haplo-HSCT yield comparable 5-year OS. Haploidentical related donors serve as a reliable alternative when fully matched donors are unavailable. (2) No statistically significant difference in 5-year overall survival (OS) was observed among the CA, FCA, and FMA conditioning regimens. (3) the FMA regimen may be considered as a favorable alternative to avoid the cyclophosphamide related toxicities.",
  "abstract_shown": true,
  "affiliations": [
    "Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology,FUjian Medical University Union Hospital",
    "Translational Medicine Center on Hematology, Fujian Medical University"
  ],
  "article_type": "research support, non u.s. gov't",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ting Lin"
    },
    {
      "affs": [
        0
      ],
      "name": "Xianlin Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaohong Yuan"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhijuan Zhu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Nainong Li"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiaofan Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4ytd2ctpnays3.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1936533",
  "fulltext_url": "https://europepmc.org/articles/PMC13677466",
  "id": "4ytd2ctpnays3",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1936533/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2720|Hematopoietic Stem Cell Transplantation"
    ]
  ],
  "openalex": "W7219759869",
  "pdf_url": "https://europepmc.org/articles/PMC13677466?pdf=render",
  "pmcid": "PMC13677466",
  "pmid": "42898257",
  "published": "2026-10-05",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/4ytd2ctpnays3.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1936533",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1936533/full"
    },
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42898257",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898257"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "title": "Comparative prognostic analysis of allogeneic hematopoietic stem cell transplantation regimens in the treatment of severe aplastic anemia",
  "title_text": "Comparative prognostic analysis of allogeneic hematopoietic stem cell transplantation regimens in the treatment of severe aplastic anemia",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:37Z",
  "url": "https://research.draconitic.com/paper/4ytd2ctpnays3",
  "venue": "Frontiers in Immunology",
  "versions": []
}