AUTHOR=Liu Limin , Miao Miao , He Hailong , Wang Shunqing , Zhang Yanming , Guo Ailian , Jiao Wenjing , Lei Meiqing , Cai Yifeng , Shangguan Xiaohui , Liu Zefa , Xu Jinge , Li Xiaoli , Zhang Liansheng , Wu Depei 

TITLE=Severe aplastic anemia patients with infection who received an allogeneic hematopoietic stem cell transplantation had a better chance: Long-term outcomes of a multicenter study

JOURNAL=Frontiers in Immunology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.955095

DOI=10.3389/fimmu.2022.955095

ISSN=1664-3224

ABSTRACT=<sec><title>Background and aims</title><p>How to select the treatment is a challenge for the management of acquired patients with infections. This study aimed at comparing the outcomes of SAA with infections who had an allogeneic hematopoietic stem cell transplantation (allo-HSCT)with that of patients who had an infection and received non-HSCT therapy.</p></sec><sec><title>Methods</title><p>We retrospectively compared the outcomes of patients with acquired SAA and infections who had an allo-HSCT (<italic>n</italic> = 141) with that of patients who had an infection and received non-HSCT therapy (n = 186) between July 2004 and January 2020.</p></sec><sec><title>Results</title><p>The treatment-related mortality (TRM) of grade 1-2 infections in the HSCT and non-HSCT groups was 24.99% and 13.68%, respectively (<italic>P =</italic> 0.206), while the TRM of grade 3-4 infections was lower in the HSCT group than that observed in the non-HSCT group (18.54% vs. 33.33%, <italic>P =</italic> 0.036). At 6 months post-treatment, 91.30% patients in the HSCT group and 8.78% patients in the non-HSCT group had achieved a normal blood profile (<italic>P</italic> &lt; 0.0001). The time required to discontinue transfusions of red blood cells and platelets in the non-HSCT group was longer than in the HSCT group (<italic>P</italic> &lt; 0.0001). Estimated overall survival (OS) at 6 years was similar in the two groups (75.5% ± 3.9% vs. 76.3% ± 3.1%, <italic>P</italic> = 0.996), while the estimated failure-free survival (FFS) at 6 years was 75.2% ± 3.8% in the HSCT group and 48.9% ± 3.7% in the non-HSCT group (<italic>P</italic> &lt; 0.0001). Multivariate analysis showed that younger age, lower grade of infection (grade 1-2), and SAA (vs. very SAA) were favorable factors for OS (<italic>P</italic> &lt; 0.05), and that the choice of HSCT and younger age were favorable factors for FFS (<italic>P</italic> &lt; 0.0001).</p></sec><sec><title>Conclusion</title><p>These results suggest that allo-HSCT has a better chance of a successful outcome than non-HSCT in SAA patients with an infection.</p></sec>