Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical hematopoietic stem cell transplantation in acute myeloid leukemia

doi:10.1007/s11684-019-0702-z

Front. Med.

2019, Vol. 13

Issue (6) : 667-679 https://doi.org/10.1007/s11684-019-0702-z

RESEARCH ARTICLE

Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical hematopoietic stem cell transplantation in acute myeloid leukemia

Meng Lv¹, Xiaohui Zhang¹, Lanping Xu¹, Yu Wang¹, Chenhua Yan¹, Huan Chen¹, Yuhong Chen¹, Wei Han¹, Fengrong Wang¹, Jingzhi Wang¹, Kaiyan Liu¹, Xiaojun Huang^1,², Xiaodong Mo¹(

)

¹. Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
². Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100044, China

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Abstract

Chronic graft-versus-host disease (cGVHD) is a major complication following unmanipulated haploidentical hematopoietic stem cell transplantation (haplo-HSCT). We aimed to identify the risk factors for cGVHD in patients who underwent anti-thymocyte globulin-based haplo-HSCT for acute myeloid leukemia (n=280). The diagnosis of cGVHD was in accordance with the National Institutes of Health consensus criteria. A total of 169 patients suffered from cGVHD. The patients who had 3 loci mismatched had a higher 8-year incidence of cGVHD (total, 66.0% vs. 53.7%, P=0.031; moderate to severe, 42.4% vs. 30.1%, P=0.036) than the patients who had 1 to 2 loci mismatched. The patients who had maternal donors had a higher 8-year incidence of moderate to severe cGVHD (49.2% vs. 32.9%, P=0.024) compared with the patients who had other donors. The patients who had grades III to IV acute GVHD (aGVHD) had higher 8-year incidence of cGVHD (total, 88.0% vs. 50.4%, P<0.001; moderate to severe, 68.0% vs. 27.0%, P<0.001) compared with the patients without aGVHD. In multivariate analysis, grades III to IV aGVHD was the only independent risk factor for cGVHD. Thus, further interventions should be considered in patients with severe aGVHD to prevent cGVHD.

Keywords acute graft-versus-host disease chronic graft-versus-host disease National Institutes of Health consensus criteria acute myeloid leukemia anti-thymocyte globulin

Corresponding Author(s): Xiaodong Mo

Just Accepted Date: 24 July 2019 Online First Date: 23 September 2019 Issue Date: 16 December 2019

Cite this article:

Meng Lv,Xiaohui Zhang,Lanping Xu, et al. Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical hematopoietic stem cell transplantation in acute myeloid leukemia[J]. Front. Med., 2019, 13(6): 667-679.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-019-0702-z
https://academic.hep.com.cn/fmd/EN/Y2019/V13/I6/667

Tab.1 Characteristics of patients

Tab.2 Characteristics of cGVHD after haplo-HSCT

Variables	Total cGVHD				Moderate to severe cGVHD
	Univariable analysis		Multivariate analysis		Univariable analysis		Multivariate analysis
	HR (95% CI)	P value	HR (95% CI)	P value	HR (95% CI)	P value	HR (95% CI)	P value
Patient characteristics
Gender
Male	1				1
Female	1.08 (0.79–1.46)	0.644			1.02 (0.69–1.52)	0.912
Age
<median	1				1
≥median	1.02 (0.75–1.38)	0.897			1.02 (0.69–1.50)	0.934
HCT-CI scores
0−2	1				1
≥3	0.69 (0.42–1.14)	0.148			0.71 (0.37–1.37)	0.308
Disease characteristics
Disease status before haplo-HSCT
CR1	1				1
CR2	0.86 (0.51–1.44)	0.562			0.94 (0.49–1.81)	0.859
Adverse cytogenetics
No	1				1
Yes	1.10 (0.54–2.25)	0.785			0.84 (0.31–2.28)	0.728
Time from diagnosis to HSCT
<6 months	1				1
≥6 months	0.89 (0. 64–1.22)	0.463			0.87 (0.58–1.32)	0.517
Donor characteristics
HLA disparity
1 locus	1				1
2 loci	1.60 (0.88–2.92)	0.124			2.01 (0.85–4.79)	0.113
3 loci	2.03 (1.14–3.63)	0.017			2.67 (1.16–6.18)	0.022
Donor type
Others	1				1
Maternal donors	1.22 (0.86–1.73)	0.267			1.64 (1.07–2.52)	0.022
Donor–recipient sex matched
Others	1				1
Female donor/male recipient	1.06 (0.74–1.52)	0.745			1.21 (0.77–1.90)	0.409
ABO matched
Matched/minor mismatched	1				1
Major/major-minor mismatched	1.03 (0.76–1.40)	0.829			0.77 (0.52–1.15)	0.201
aGVHD after haplo-HSCT
None	1		1		1		1
Grades I to II	1.38 (0.99–1.92)	0.058	1.36 (0.98–1.90)	0.070	1.56 (1.00–2.43)	0.048	1.52 (0.98–2.37)	0.063
Grades III to IV	2.49 (1.52–4.09)	<0.001	2.40 (1.46–3.93)	0.001	3.55 (1.96–6.42)	<0.001	3.09 (1.69–5.66)	< 0.001
Infection after haplo-HSCT
Cytomegalovirus infection
None	1				1
Cytomegaloviremia	1.10 (0.81–1.49)	0.537			1.17 (0.79–1.73)	0.433
Cytomegalovirus disease	1.59 (0.78–3.24)	0.199			1.48 (0.60–3.63)	0.394
Epstein-Barr virus infection
None	1				1
Epstein-Barr viremia	1.19 (0.56–2.54)	0.652			1.41 (0.57–3.46)	0.456
PTLD	1.46 (0.46–4.58)	0.519			1.56 (0.38–6.35)	0.533

Tab.3 Risk factors for cGVHD after haplo-HSCT

Fig.1 cGVHD according to HLA disparity and donor–recipient relation. (A) HLA disparity and total cGVHD; (B) HLA disparity and moderate to severe cGVHD; (C) Donor–recipient relationship and moderate to severe cGVHD. cGVHD, chronic graft-versus-host disease.

Fig.2 cGVHD according to aGVHD severity. (A) aGVHD and total cGVHD; (B) aGVHD and moderate to severe cGVHD. aGVHD, acute graft-versus-host disease; cGVHD, chronic graft-versus-host disease.

Fig.3 Clinical outcomes according to cGVHD grading. (A) relapse; (B) non-relapse mortality; (C) disease-free survival; (D) overall survival. cGVHD, chronic graft-versus-host disease; DFS, disease-free survival; NRM, non-relapse mortality; OS, overall survival.

1	XJ Huang, HH Zhu, YJ Chang, LP Xu, DH Liu, XH Zhang, B Jiang, Q Jiang, H Jiang, YH Chen, H Chen, W Han, KY Liu, Y Wang. The superiority of haploidentical related stem cell transplantation over chemotherapy alone as postremission treatment for patients with intermediate- or high-risk acute myeloid leukemia in first complete remission. Blood 2012; 119(23): 5584–5590 https://doi.org/10.1182/blood-2011-11-389809 pmid: 22535659
2	J Reiffers, AM Stoppa, M Attal, M Michallet, G Marit, D Blaise, F Huguet, B Corront, P Cony-Makhoul, JA Gastaut, G Laurent, L Molina, A Broustet, D Maraninchi, J Pris, D Hollard, C Faberes. Allogeneic vs autologous stem cell transplantation vs chemotherapy in patients with acute myeloid leukemia in first remission: the BGMT 87 study. Leukemia 1996; 10(12): 1874–1882 pmid: 8946925
3	HM Lazarus, WS Pérez, JP Klein, C Kollman, B Bate-Boyle, CN Bredeson, RP Gale, RB Geller, A Keating, MR Litzow, DI Marks, CB Miller, J Douglas Rizzo, TR Spitzer, DJ Weisdorf, MJ Zhang, MM Horowitz. Autotransplantation versus HLA-matched unrelated donor transplantation for acute myeloid leukaemia: a retrospective analysis from the Center for International Blood and Marrow Transplant Research. Br J Haematol 2006; 132(6): 755–769 https://doi.org/10.1111/j.1365-2141.2005.05947.x pmid: 16487177
4	M Lv , Y Chang, X Huang. Everyone has a donor: contribution of the Chinese experience to global practice of haploidentical hematopoietic stem cell transplantation. Front Med 2019; 13(1): 45–56 https://doi.org/10.1007/s11684-017-0595-7. pmid: 29675688
5	LP Xu, DP Wu, MZ Han, H Huang, QF Liu, DH Liu, ZM Sun, LH Xia, J Chen, HX Wang, C Wang, CF Li, YR Lai, JM Wang, DB Zhou, H Chen, YP Song, T Liu, KY Liu, XJ Huang. A review of hematopoietic cell transplantation in China: data and trends during 2008–2016. Bone Marrow Transplant 2017; 52(11): 1512–1518 https://doi.org/10.1038/bmt.2017.59 pmid: 28436973
6	L Xu, H Chen, J Chen, M Han, H Huang, Y Lai, D Liu, Q Liu, T Liu, M Jiang, H Ren, Y Song, Z Sun, J Wang, D Wu, D Zhou, P Zou, K Liu, X Huang. The consensus on indications, conditioning regimen, and donor selection of allogeneic hematopoietic cell transplantation for hematological diseases in China-recommendations from the Chinese Society of Hematology. J Hematol Oncol 2018; 11(1): 33 https://doi.org/10.1186/s13045-018-0564-x pmid: 29495966
7	Y Wang, QF Liu, LP Xu, KY Liu, XH Zhang, X Ma, ZP Fan, DP Wu, XJ Huang. Haploidentical vs. identical-sibling transplant for AML in remission: a multicenter, prospective study. Blood 2015; 125(25): 3956–3962 https://doi.org/10.1182/blood-2015-02-627786 pmid: 25940714
8	XD Mo, XH Zhang, LP Xu, Y Wang, CH Yan, H Chen, YH Chen, W Han, FR Wang, JZ Wang, KY Liu, XJ Huang. Unmanipulated haploidentical hematopoietic stem cell transplantation in first complete remission can abrogate the poor outcomes of children with acute myeloid leukemia resistant to the first course of induction chemotherapy. Biol Blood Marrow Transplant 2016; 22(12): 2235–2242 https://doi.org/10.1016/j.bbmt.2016.09.004 pmid: 27614057
9	XD Mo, LP Xu, XH Zhang, DH Liu, Y Wang, H Chen, CH Yan, YH Chen, W Han, FR Wang, JZ Wang, KY Liu, XJ Huang. Chronic GVHD induced GVL effect after unmanipulated haploidentical hematopoietic SCT for AML and myelodysplastic syndrome. Bone Marrow Transplant 2015; 50(1): 127–133 https://doi.org/10.1038/bmt.2014.223 pmid: 25387095
10	PL Weiden, KM Sullivan, N Flournoy, R Storb, ED Thomas; Seattle Marrow Transplant Team. Antileukemic effect of chronic graft-versus-host disease: contribution to improved survival after allogeneic marrow transplantation. N Engl J Med 1981; 304(25): 1529–1533 https://doi.org/10.1056/NEJM198106183042507 pmid: 7015133
11	MM Horowitz, RP Gale, PM Sondel, JM Goldman, J Kersey, HJ Kolb, AA Rimm, O Ringdén, C Rozman, B Speck, RT Truitt, FE Zwaan, MM Bortin. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990; 75(3): 555–562 pmid: 2297567
12	TH Terwey, TM Le Duc, PG Hemmati, P le Coutre, M Nagy, P Martus, B Dörken, R Arnold. NIH-defined graft-versus-host disease and evidence for a potent graft-versus-leukemia effect in patients with acute lymphoblastic leukemia. Ann Oncol 2013; 24(5): 1363–1370 https://doi.org/10.1093/annonc/mds615 pmid: 23247660
13	C Saillard, R Crocchiolo, S Furst, J El-Cheikh, L Castagna, A Signori, C Oudin, C Faucher, C Lemarie, C Chabannon, A Granata, D Blaise. National Institutes of Health classification for chronic graft-versus-host disease predicts outcome of allo-hematopoietic stem cell transplant after fludarabine-busulfan-antithymocyte globulin conditioning regimen. Leuk Lymphoma 2014; 55(5): 1106–1112 https://doi.org/10.3109/10428194.2013.820285 pmid: 23822538
14	D Wolff, A Gerbitz, F Ayuk, A Kiani, GC Hildebrandt, GB Vogelsang, S Elad, A Lawitschka, G Socie, SZ Pavletic, E Holler, H Greinix. Consensus conference on clinical practice in chronic graft-versus-host disease (GVHD): first-line and topical treatment of chronic GVHD. Biol Blood Marrow Transplant 2010; 16(12): 1611–1628 https://doi.org/10.1016/j.bbmt.2010.06.015 pmid: 20601036
15	YJ Chang, Y Wang, XD Mo, XH Zhang, LP Xu, CH Yan, H Chen, YH Chen, Y Chen, W Han, FR Wang, JZ Wang, KY Liu, XJ Huang. Optimal dose of rabbit thymoglobulin in conditioning regimens for unmanipulated, haploidentical, hematopoietic stem cell transplantation: long-term outcomes of a prospective randomized trial. Cancer 2017; 123(15): 2881–2892 https://doi.org/10.1002/cncr.30540 pmid: 28301690
16	Y Wang, DH Liu, KY Liu, LP Xu, XH Zhang, W Han, H Chen, YH Chen, XJ Huang. Impact of pretransplantation risk factors on post transplantation outcome of patients with acute myeloid leukemia in remission after haploidentical hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2013; 19(2): 283–290 https://doi.org/10.1016/j.bbmt.2012.10.002 pmid: 23063629
17	HJ Kolb, J Mittermüller, C Clemm, E Holler, G Ledderose, G Brehm, M Heim, W Wilmanns. Donor leukocyte transfusions for treatment of recurrent chronic myelogenous leukemia in marrow transplant patients. Blood 1990; 76(12): 2462–2465 pmid: 2265242
18	R Storb, RL Prentice, KM Sullivan, HM Shulman, HJ Deeg, KC Doney, CD Buckner, RA Clift, RP Witherspoon, FA Appelbaum, JE Sanders, PS Stewart, ED Thomas. Predictive factors in chronic graft-versus-host disease in patients with aplastic anemia treated by marrow transplantation from HLA-identical siblings. Ann Intern Med 1983; 98(4): 461–466 https://doi.org/10.7326/0003-4819-98-4-461 pmid: 6340576
19	O Ringdén, T Paulin, B Lönnqvist, B Nilsson. An analysis of factors predisposing to chronic graft-versus-host disease. Exp Hematol 1985; 13(10): 1062–1067 pmid: 2996920
20	K Atkinson, MM Horowitz, RP Gale, DW van Bekkum, E Gluckman, RA Good, N Jacobsen, HJ Kolb, AA Rimm, O Ringdén, C Rozman, KA Sobocinski, FE Zwaan, MM Bortin. Risk factors for chronic graft-versus-host disease after HLA-identical sibling bone marrow transplantation. Blood 1990; 75(12): 2459–2464 pmid: 2350582
21	SK Sohn, DH Kim, JH Baek, JG Kim, KB Lee, KH Lee, JH Lee, SJ Choi, JH Lee, IH Shin. Risk-factor analysis for predicting progressive- or quiescent-type chronic graft-versus-host disease in a patient cohort with a history of acute graft-versus-host disease after allogeneic stem cell transplantation. Bone Marrow Transplant 2006; 37(7): 699–708 https://doi.org/10.1038/sj.bmt.1705313 pmid: 16501588
22	F Yang, D Lu, Y Hu, X Huang, H Huang, J Chen, D Wu, J Wang, C Wang, M Han, H Chen. Risk factors for graft-versus-host disease after transplantation of hematopoietic stem cells from unrelated donors in the China marrow donor program. Ann Transplant 2017; 22: 384–401 https://doi.org/10.12659/AOT.902805 pmid: 28652564
23	Y Wang, DH Liu, KY Liu, LP Xu, XH Zhang, W Han, H Chen, YH Chen, FR Wang, JZ Wang, YQ Sun, XJ Huang. Long-term follow-up of haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for the treatment of leukemia: nine years of experience at a single center. Cancer 2013; 119(5): 978–985 https://doi.org/10.1002/cncr.27761 pmid: 23097265
24	CH Yan, DH Liu, KY Liu, LP Xu, YR Liu, H Chen, W Han, Y Wang, YZ Qin, XJ Huang. Risk stratification-directed donor lymphocyte infusion could reduce relapse of standard-risk acute leukemia patients after allogeneic hematopoietic stem cell transplantation. Blood 2012; 119(14): 3256–3262 https://doi.org/10.1182/blood-2011-09-380386 pmid: 22337715
25	XJ Huang, DH Liu, KY Liu, LP Xu, H Chen, W Han, YH Chen, JZ Wang, ZY Gao, YC Zhang, Q Jiang, HX Shi, DP Lu. Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies. Bone Marrow Transplant 2006; 38(4): 291–297 https://doi.org/10.1038/sj.bmt.1705445 pmid: 16883312
26	XJ Huang, DH Liu, KY Liu, LP Xu, H Chen, W Han, YH Chen, XH Zhang, DP Lu. Treatment of acute leukemia with unmanipulated HLA-mismatched/haploidentical blood and bone marrow transplantation. Biol Blood Marrow Transplant 2009; 15(2): 257–265 https://doi.org/10.1016/j.bbmt.2008.11.025 pmid: 19167686
27	AH Filipovich, D Weisdorf, S Pavletic, G Socie, JR Wingard, SJ Lee, P Martin, J Chien, D Przepiorka, D Couriel, EW Cowen, P Dinndorf, A Farrell, R Hartzman, J Henslee-Downey, D Jacobsohn, G McDonald, B Mittleman, JD Rizzo, M Robinson, M Schubert, K Schultz, H Shulman, M Turner, G Vogelsang, ME Flowers. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant 2005; 11(12): 945–956 https://doi.org/10.1016/j.bbmt.2005.09.004 pmid: 16338616
28	ML Slovak, KJ Kopecky, PA Cassileth, DH Harrington, KS Theil, A Mohamed, E Paietta, CL Willman, DR Head, JM Rowe, SJ Forman, FR Appelbaum. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood 2000; 96(13): 4075–4083 pmid: 11110676
29	ML Sorror, MB Maris, R Storb, F Baron, BM Sandmaier, DG Maloney, B Storer. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 2005; 106(8): 2912–2919 https://doi.org/10.1182/blood-2005-05-2004 pmid: 15994282
30	TA Gooley, W Leisenring, J Crowley, BE Storer. Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med 1999; 18(6): 695–706 https://doi.org/10.1002/(SICI)1097-0258(19990330)18:6<695::AID-SIM60>3.0.CO;2-O pmid: 10204198
31	S Arai, M Jagasia, B Storer, X Chai, J Pidala, C Cutler, M Arora, DJ Weisdorf, ME Flowers, PJ Martin, J Palmer, D Jacobsohn, SZ Pavletic, GB Vogelsang, SJ Lee. Global and organ-specific chronic graft-versus-host disease severity according to the 2005 NIH Consensus Criteria. Blood 2011; 118(15): 4242–4249 https://doi.org/10.1182/blood-2011-03-344390 pmid: 21791424
32	A Ruggeri, Y Sun, M Labopin, A Bacigalupo, F Lorentino, W Arcese, S Santarone, Z Gülbas, D Blaise, G Messina, A Ghavamzadeh, F Malard, B Bruno, JL Diez-Martin, Y Koc, F Ciceri, M Mohty, A Nagler. Post-transplant cyclophosphamide versus anti-thymocyte globulin as graft-versus-host disease prophylaxis in haploidentical transplant. Haematologica 2017; 102(2): 401–410 https://doi.org/10.3324/haematol.2016.151779 pmid: 27758821
33	A Bashey, MJ Zhang, SR McCurdy, A St Martin, T Argall, C Anasetti, SO Ciurea, O Fasan, S Gaballa, M Hamadani, P Munshi, MM Al Malki, R Nakamura, PV O’Donnell, MA Perales, K Raj, R Romee, S Rowley, V Rocha, RB Salit, M Solh, RJ Soiffer, EJ Fuchs, M Eapen. Mobilized peripheral blood stem cells versus unstimulated bone marrow as a graft source for T-cell-replete haploidentical donor transplantation using post-transplant cyclophosphamide. J Clin Oncol 2017; 35(26): 3002–3009 https://doi.org/10.1200/JCO.2017.72.8428 pmid: 28644773
34	ME Flowers, Y Inamoto, PA Carpenter, SJ Lee, HP Kiem, EW Petersdorf, SE Pereira, RA Nash, M Mielcarek, ML Fero, EH Warren, JE Sanders, RF Storb, FR Appelbaum, BE Storer, PJ Martin. Comparative analysis of risk factors for acute graft-versus-host disease and for chronic graft-versus-host disease according to National Institutes of Health consensus criteria. Blood 2011; 117(11): 3214–3219 https://doi.org/10.1182/blood-2010-08-302109 pmid: 21263156
35	M Grube, E Holler, D Weber, B Holler, W Herr, D Wolff. Risk factors and outcome of chronic graft-versus-host disease after allogeneic stem cell transplantation-results from a single-center observational study. Biol Blood Marrow Transplant 2016; 22(10): 1781–1791 https://doi.org/10.1016/j.bbmt.2016.06.020 pmid: 27343720
36	M Remberger, G Kumlien, J Aschan, L Barkholt, P Hentschke, P Ljungman, J Mattsson, J Svennilson, O Ringdén. Risk factors for moderate-to-severe chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2002; 8(12): 674–682 https://doi.org/10.1053/bbmt.2002.v8.abbmt080674 pmid: 12523580
37	Y Wang, YJ Chang, LP Xu, KY Liu, DH Liu, XH Zhang, H Chen, W Han, YH Chen, FR Wang, JZ Wang, Y Chen, CH Yan, MR Huo, D Li, XJ Huang. Who is the best donor for a related HLA haplotype-mismatched transplant? Blood 2014; 124(6): 843–850 https://doi.org/10.1182/blood-2014-03-563130 pmid: 24916508
38	S Tamaki, T Ichinohe, K Matsuo, N Hamajima, N Hirabayashi, H Dohy; Japan Society of Hematopoietic Cell Transplantation. Superior survival of blood and marrow stem cell recipients given maternal grafts over recipients given paternal grafts. Bone Marrow Transplant 2001; 28(4): 375–380 https://doi.org/10.1038/sj.bmt.1703146 pmid: 11571510
39	Y Wang, HX Fu, DH Liu, LP Xu, XH Zhang, YJ Chang, YH Chen, FR Wang, YQ Sun, FF Tang, KY Liu, XJ Huang. Influence of two different doses of antithymocyte globulin in patients with standard-risk disease following haploidentical transplantation: a randomized trial. Bone Marrow Transplant 2014; 49(3): 426–433 https://doi.org/10.1038/bmt.2013.191 pmid: 24292519
40	YJ Chang, LP Xu, Y Wang, XH Zhang, H Chen, YH Chen, FR Wang, W Han, YQ Sun, CH Yan, FF Tang, XD Mo, KY Liu, XJ Huang. Controlled, randomized, open-label trial of risk-stratified corticosteroid prevention of acute graft-versus-host disease after haploidentical transplantation. J Clin Oncol 2016; 34(16): 1855–1863 https://doi.org/10.1200/JCO.2015.63.8817 pmid: 27091717
41	YJ Chang, LP Xu, Y Wang, XH Zhang, H Chen, YH Chen, FR Wang, W Han, YQ Sun, CH Yan, FF Tang, XD Mo, KY Liu, XJ Huang. Effects of low-dose glucocorticoid prophylaxis on chronic GVHD and GVHD-free, relapse-free survival after haploidentical transplantation: long-term follow-up of a controlled, randomized open-label trial. Biol Blood Marrow Transplant 2019; 25(3): 529–537 https://doi.org/10.1016/j.bbmt.2018.11.020 pmid: 30481596
42	XD Mo, YY Zhang, XH Zhang, LP Xu, Y Wang, CH Yan, H Chen, YH Chen, YJ Chang, KY Liu, XJ Huang. The role of collateral related donors in haploidentical hematopoietic stem cell transplantation. Sci Bull (Beijing) 2018; 63(20): 1376–1382 https://doi.org/10.1016/j.scib.2018.08.008
43	DP Lu, L Dong, T Wu, XJ Huang, MJ Zhang, W Han, H Chen, DH Liu, ZY Gao, YH Chen, LP Xu, YC Zhang, HY Ren, D Li, KY Liu. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation. Blood 2006; 107(8): 3065–3073 https://doi.org/10.1182/blood-2005-05-2146 pmid: 16380454
44	MR Huo, XY Pei, D Li, YJ Chang, LP Xu, XH Zhang, KY Liu, XJ Huang. Impact of HLA allele mismatch at HLA-A, -B, -C, -DRB1, and -DQB1 on outcomes in haploidentical stem cell transplantation. Bone Marrow Transplant 2018; 53(5): 600–608 https://doi.org/10.1038/s41409-017-0072-6 pmid: 29335631
45	F Lorentino, M Labopin, K Fleischhauer, F Ciceri, CR Mueller, A Ruggeri, A Shimoni, M Bornhäuser, A Bacigalupo, Z Gülbas, Y Koc, W Arcese, B Bruno, J Tischer, D Blaise, G Messina, DW Beelen, A Nagler, M Mohty. The impact of HLA matching on outcomes of unmanipulated haploidentical HSCT is modulated by GVHD prophylaxis. Blood Adv 2017; 1(11): 669–680 https://doi.org/10.1182/bloodadvances.2017006429 pmid: 29296709
46	CA Keever-Taylor, C Bredeson, FR Loberiza, JT Casper, C Lawton, D Rizzo, WH Burns, DA Margolis, DH Vesole, M Horowitz, MJ Zhang, M Juckett, WR Drobyski. Analysis of risk factors for the development of GVHD after T cell-depleted allogeneic BMT: effect of HLA disparity, ABO incompatibility, and method of T-cell depletion. Biol Blood Marrow Transplant 2001; 7(11): 620–630 https://doi.org/10.1053/bbmt.2001.v7.pm11760150 pmid: 11760150
47	M Kondo, S Kojima, K Horibe, K Kato, T Matsuyama. Risk factors for chronic graft-versus-host disease after allogeneic stem cell transplantation in children. Bone Marrow Transplant 2001; 27(7): 727–730 https://doi.org/10.1038/sj.bmt.1702868 pmid: 11360113
48	S Carlens, O Ringdén, M Remberger, B Lönnqvist, H Hägglund, S Klaesson, J Mattsson, BM Svahn, J Winiarski, P Ljungman, J Aschan. Risk factors for chronic graft-versus-host disease after bone marrow transplantation: a retrospective single centre analysis. Bone Marrow Transplant 1998; 22(8): 755–761 https://doi.org/10.1038/sj.bmt.1701423 pmid: 9827972

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[1]	Xiaoxiao Chen, Yanjing Tang, Jing Chen, Ru Chen, Longjun Gu, Huiliang Xue, Ci Pan, Jingyan Tang, Shuhong Shen. Homoharringtonine is a safe and effective substitute for anthracyclines in children younger than 2 years old with acute myeloid leukemia[J]. Front. Med., 2019, 13(3): 378-387.
[2]	Zhan Su, Fengyu Wu, Weiyu Hu, Xiaodan Liu, Shaoling Wu, Xianqi Feng, Zhongguang Cui, Jie Yang, Zhenguang Wang, Hongzai Guan, Hongguo Zhao, Wei Wang, Chunting Zhao, Jun Peng. Philadelphia chromosome-positive acute myeloid leukemia with masses and osteolytic lesions: finding of 18F-FDG PET/CT[J]. Front. Med., 2017, 11(3): 440-444.
[3]	Yuting Tan,Han Liu,Saijuan Chen. Mutant DNA methylation regulators endow hematopoietic stem cells with the preleukemic stem cell property, a requisite of leukemia initiation and relapse[J]. Front. Med., 2015, 9(4): 412-420.
[4]	Felicitas THOL, Arnold GANSER. Molecular pathogenesis of acute myeloid leukemia: A diverse disease with new perspectives[J]. Front. Med., 2010, 4(4): 356-362.

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