No differences in hemostatic and endothelial activations between haploidentical and matched-donor hematopoietic stem cel
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(2020) 18:21
LETTER TO THE EDITOR
Open Access
No differences in hemostatic and endothelial activations between haploidentical and matched-donor hematopoietic stem cell transplantation in thalassemia disease Surapong Lertthammakiat1,2, Peerasit Sitthirat3, Usanarat Anurathapan1, Duantida Songdej1, Samart Pakakasama1, Ampaiwan Chuansumrit1, Nattaphat Putawornsub3, Sawitt Sirasittikarn3, Sataporn Wantanawijarn3, Praguywan Kadegasem1, Suradej Hongeng1 and Nongnuch Sirachainan1*
Abstract Hemostatic changes and endothelial activations have been recognized in β-thalassemic patients after matcheddonor hematopoietic stem cell transplantation (HSCT) but there are limited studies for haploidentical HSCT. This report demonstrates that the levels of hemostatic and endothelial markers, including thrombin antithrombin complex, prothrombin fragment, D-dimer, von Willebrand factor antigen and thrombomodulin levels, were not significantly different between haploidentical and matched-donor HSCT patients. Keywords: Endothelial activation, Hemostasis, Thalassemia, Haploidentical hematopoietic stem cell transplantation
Key points 1) HSCT-induced hemostatic changes and endothelial activations 2) Haploidentical and matched-donor HSCT had similar hemostatic changes and endothelial activations 3) Evidence of hemostatic changes and endothelial activations presented during the first year after HSCT
Background β-thalassemia disease is caused by reduced or absent βglobin chain synthesis. Most patients with these * Correspondence: [email protected] 1 Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi District, Bangkok, Thailand Full list of author information is available at the end of the article
conditions have moderate to severe anemia, requiring regular red blood cell transfusions [1–4]. The curative treatment for severe thalassemia disease is a matcheddonor hematopoietic stem cell transplantation (HSCT). However, the chance of having a matched-donor HSCT is less than 50%. At present, haploidentical HSCT has been increasingly used to treat various diseases, including malignancy and hemoglobinopathy. Although haploidentical HSCT is expected to have more complications after HSCT, protocols to reduce complications and graft failure have been developed, such as CD34 selection with reduced T cells as a stem cell source. In previous studies, in order to reduce complications, patients who underwent haploidentical HSCT received two cycles of pre-transplantation immunosuppression before a conditioning regimen of fludarabine and busulfan [5–7]. The same studies had a conditioning regimen of busulfan
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