A comparative study of the impact of lineal relatives versus collateral relatives donor on prognosis in haplo-HSCT for aplastic anemia

Objective: To investigate the impact of Lineal and Collateral donors on the prognosis of recipients in haplo-HSCT for AA among relatives. Methods: A retrospective analysis of data from AA patients who underwent haplo-HSCT at our center from January 2018 to January 2025. Patients were grouped based on the kinship between donors and recipients (Lineal vs. Collateral), and comparisons were made across key indicators, including engraftment, viral reactivation, GVHD, OS, and GRFS. Results: = 0.062) were relatively higher in the Collateral group compared to the Lineal group. Further analysis revealed that younger donors (age ≤ 40 years) and younger patients (age ≤ 40 years) contributed significantly to improved outcomes in the Collateral group, with both 3-year OS and GRFS being significantly better than in the Lineal group. Conclusion: The study suggests that Collateral donors represent a viable and effective option, particularly in the absence of Lineal donors. The age of the donor and recipient is a critical factor influencing transplantation outcomes, with younger donors and patients potentially enhancing therapeutic efficacy.