HLA相合同胞异基因外周血造血干细胞移植治疗急性白血病

背景：HLA相合同胞间异基因外周血造血干细胞移植是治疗急性白血病的一种有效方法。 目的：评价HLA相合异基因外周血造血干细胞移植治疗急性白血病的临床疗效及并发症。 方法：25例急性白血病患者接受HLA相合同胞的异基因外周血造血干细胞移植,其中急性髓系白血病20例,急性淋巴细胞白血病5例。预处理方案为BU+CY方案或CY+TBI方案,移植物抗宿主病预防采用环孢素A+吗替麦考酚酯+短程甲氨蝶呤。 结果：最短随访2个月,最长随访80个月。患者均获造血重建,中性粒细胞≥0.5×10⁹ L^-1的时间为10~18 d,血小板≥20× 10⁹ L^-1的时间为10~37 d。主要并发症：感染败血症12例,巨细胞病毒感染9例,带状疱疹病毒感染3例,发生急性移植物抗宿主病10例,慢性移植物抗宿主病11例,出血性膀胱炎4例。至随访结束,17例无病生存,8例死亡。提示HLA相合同胞异基因外周血造血干细胞移植是治疗急性白血病安全有效的方法。     

单倍体相合造血干细胞移植治疗高危白血病

背景：异基因造血干细胞移植是治疗高危白血病的主要方法,单倍体相合的造血干细胞移植扩展了移植的应用范围。 目的：观察“改良Bu/Cy+ATG”为预处理方案的单倍体相合造血干细胞移植治疗高危白血病的疗效。 方法：对19例高危白血病患者,均采用“改良Bu/Cy+ATG”预处理方案,采用外周血造血干细胞移植5例,外周血+骨髓造血干细胞移植14例。应用甲氨蝶呤,环孢素A,吗替麦考酚酯预防移植物抗宿主病。 结果与结论：①短期疗效：中性粒细胞恢复的中位时间为12(8~20) d;血小板恢复的中位时间为13(10~31) d;移植后100 d内,移植相关死亡率为(15.8±8.4)%。②移植物抗宿主病发生情况：Ⅰ~Ⅳ度急性移植物抗宿主病总发生率(63.1±11.1)%,慢性移植物抗宿主病发生率(54.54±15.0)%。③远期疗效：2年无病生存率为(28.2±15.5)%,2年总体生存率为(46.9±16.5)%。结果提示,高危白血病无人类白细胞抗原相合血缘供者及无人类白细胞抗原相合非血缘供者,而又急需进行挽救性移植时,“改良Bu/Cy+ATG”为预处理方案的单倍体相合造血干细胞移植是一种可行的选择。     

单倍体造血干细胞移植治疗白血病23例

BACKGROUND:Allogeneic hematopoietic stem cell transplantation (HSCT) is one of the effective methods in the treatment of leukemia. The haploidentical HSCT is an option for the patients who need a HSCT without a human leukocyte antigen (HLA)-matched donor. OBJECTIVE:To study the clinical efficacy of HLA-haploidentical HSCT on leukemia and its complications. METHODS:A total of 23 patients (4 cases of acute lymphoblastic leukemia, 12 of acute myelogenous leukemia, and 7 of chronic granulocytic leukemia) who had been treated with HLA-haploidentical HSCT from November 2007 to March 2015 were enrolled. Conditioning regimen I was set as cyclohexyl nitrosourea+cytarabine+busulfan+cyclophosphamide; regimen II as cyclophosphamide+total body irradiation; regimen III as fludarabine+cytarabine+busulfan+cyclophosphamide; and regimen IV as busulfan+cyclophosphamide. Cyclosporin A, mycophenlate mofetil, antithymocyte globulin and methotrexate were used to prevent graft-versus-host disease (GVHD). Hematopoietic remodeling, complications and prognosis were observed in all patients undergoing HLA-haploidentical HSCT. RESULTS AND CONCLUSION:Of the 23 patients, 22 achieved reconstitution of the granulocyte series, and 19 achieved reconstruction of the megakaryocyte series. Additionally, there were 7 cases of acute GVHD and 4 of chronic GVHD. Transplant-related mortality was 22% (5/23) within 100 days post transplantation including graft failure, acute GVHD, intracranial hemorrhage and disseminated infections. There were 14 cases of disease-free survival from 100 days to 24 months post transplantation, 2 cases of death due to GVHD and fungal infection, or recurrence and chronic GVHD, and 2 cases of recurrence under treatment. These findings indicate that HLA-haploidentical HSCT is an effective approach for the treatment of patients with leukemia, which is worth further investigation in clinical practice.     

异基因外周血造血干细胞移植治疗白血病*

背景：异基因外周血造血干细胞移植是治疗白血病的有效手段。 目的：比较血缘与非血缘供者异基因外周血造血干细胞移植治疗白血病的造血重建、免疫重建、感染、移植物抗宿主病及疗效。 方法：选择接受异基因外周血造血干细胞移植治疗的白血病患者45例,其中30例患者接受血缘供者造血干细胞移植(血缘组),15例患者接受非血缘供者造血干细胞移植(非血缘组)。 结果与结论：①造血重建：血缘组白细胞和血小板重建时间均快于非血缘组(P < 0.05)。在移植后30~40 d植活证据指标测定提示异体造血干细胞在受者体内完全植活。②T细胞重建：两组移植后各时间点T细胞重建差异无显著性意义。③感染发生率：两组移植后早期感染发生率,急、慢性移植物抗宿主病发生率差异无显著性意义(P > 0.05)。④白血病复发：两组移植后复发率差异无显著性意义(P > 0.05)。⑤无病生存：两组移植后2年无病生存率差异无显著性意义(P > 0.05)。表明血缘供者异基因外周血造血干细胞移植后的造血重建较非血缘供者迅速,但两者间移植后T细胞重建、感染发生率、移植物抗宿主病及无病生存并无差异。      

HLA单倍体与全相合异基因造血干细胞移植治疗恶性血液病

背景：异基因造血干细胞移植是治疗恶性血液病的一种非常有效的方法。单倍体相合的造血干细胞移植扩大了移植的应用范围,是无HLA相合供者患者的一种重要选择。 目的：比较HLA单倍体相合与全相合异基因造血干细胞移植治疗恶性血液病的临床疗效。 方法：回顾性分析接受异基因造血干细胞移植79例恶性血液病患者的临床资料,其中HLA单倍体相合组26例、全相合组53例,对比两组受者移植物抗宿主病的发生率、复发率、2年生存率等。 结果与结论：78例受者获得完全、持久供者干细胞植入;1例受者在移植后28 d尚未植入,后因感染死亡。两组慢性移植物抗宿主病发生率、复发率和2年无病生存率差异无显著性意义(P > 0.05)。单倍体相合组急性移植物抗宿主病发生率高于全相合组(P < 0.05);2年总生存率低于全相合组(P < 0.05)。提示血缘HLA单倍体相合移植治疗恶性血液病的安全性及疗效接近于全相合移植,在缺乏HLA相合供者的情况下,行HLA单倍体相合造血干细胞移植治疗恶性血液病是切实可行的选择。     

急性淋巴细胞白血病应用同胞全相合造血干细胞移植治疗的价值研究

目的:分析同胞全相合造血干细胞移植治疗急性淋巴细胞白血病的临床疗效.方法:选取我院2017年7月至2019年12月收治的82例急性淋巴细胞白血病患者,根据移植类型分为同胞全相合造血干细胞移植研究组和单倍体造血干细胞移植对照组,均41例,对比造血功能重建、并发症、预后情况等.结果:研究组中性粒细胞植入时间短于对照组,并发...     

白血病患者异基因造血干细胞移植后T细胞免疫重建的研究

目的 通过分析TCR Vβ基因片段选择性扩增，了解白血病患者异基因外周血干细胞移植后T淋巴细胞的免疫重建及其在移植物抗宿主病(GVHD)患者中的表达特点．方法 采用RT—PCR扩增10例移植后患者外周血的单个核细胞的TCR Vβ24个基因片段，分析其TCR Vβ基因的表达情况，GVHD患者的PCR产物进一步经基因扫描分析确定T细胞克隆性．结果 经24个Vβ引物所分别进行的RT—PCR检测TCR Vβ各亚家族基因的表达情况，发现10例病人外周血与正常人表达24个Vβ亚家族有明显的不同，病人的部分Vβ亚家族T细胞仍未能重建，仅表达5-22个亚家族基因；9例GVHD患者外周血仅表达2—8个TCR Vβ亚细胞生长．结论 移植后病人外周血淋巴细胞TCR Vβ基因片段部分受抑制，部分基因片段呈选择性扩增．GVHD患者有Vβ3和Vβ8基因的优势表达，并有克隆性T细胞生成．     

单倍体相合造血干细胞移植治疗儿童重型再生障碍性贫血

背景：目前治疗儿童再生障碍性贫血的主要方法为强化免疫抑制治疗或干细胞移植,后者由于供者来源少而受到限制,HLA单倍体相合的异基因造血干细胞在白血病治疗中常见应用,在再生障碍性贫血治疗中较少应用。目的：探讨单倍体相合的造血干细胞移植联合胎盘来源的间充质干细胞移植治疗重型儿童再生障碍性贫血的疗效。方法：患儿,女,7岁,确诊重型再生障碍性贫血1年半,2012-07-09接受HLA单倍体相合的异基因骨髓及外周血单个核细胞联合胎盘来源间充质干细胞移植,供者为母亲。预处理采用氟达拉滨联合环磷酰胺和抗胸腺细胞球蛋白方案。结果与结论：移植后+9 d中性粒细胞>0.5×10⁹ L^-1,+12 d完成造血重建,+100 d查STR提示植入完成。移植后+8个月停用免疫抑制药物,未发生急、慢性移植物抗宿主病。患儿随访18个月,无病生存。结果表明,HLA单倍体相合的造血干细胞联合胎盘来源间充质细胞移植治疗儿童重型再生障碍性贫血是一种安全有效、值得探索的方法。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

减低剂量预处理方案在亲缘HLA单倍体相合造血干细胞移植中的应用

背景：近年来减低剂量预处理异基因造血干细胞移植已被证明是安全有效的治疗手段,在同胞全相合和无关供者中应用逐年增多,它特别适合老年人或年轻人合并器官功能障碍的患者,然而由于找到HLA配型相合供体的概率不高,使得同胞全相合和无关供者减低剂量预处理异基因造血干细胞移植开展受限,而HLA不相合/单倍体供体则可以迅速找到,但减低剂量预处理的单倍体造血干细胞移植应用的报道还较少,国内尚未见报道,因此对减低剂量预处理的单倍体造血干细胞移植的开展情况进行综述非常重要。 目的：综述减低剂量预处理在亲缘HLA单倍体造血干细胞移植中的应用现状。 方法：以“减低剂量预处理方案、非清髓性预处理方案、HLA单倍体相合、造血干细胞移植和No-nmyeloablative  conditioning,Reduced-intensity conditioning,HLA-haploidentical,Hematopoietic stem cell transplantation”为检索词,应用计算机检索1997至2014年万方数据库、CNKI和PubMed数据库、外文医学信息资源检索平台检索关于减低剂量预处理在亲缘HLA单倍体造血干细胞移植中应用的相关文献,根据纳入标准和排除标准,最终选取25篇文献进行分析,全部为英文。 结果与结论：减低剂量预处理异基因造血干细胞移植在HLA同胞全相合及无关供者中开展的较多且效果愈来愈好。减低剂量预处理的单倍体造血干细胞移植开展的较晚且报道较少,其植入、感染、移植相关死亡、移植物抗宿主病、长期无病生存率和总生存率等各个研究的结果差异较大,早期结果稍差,而近期总体情况有明显改善。目前看减低剂量预处理的单倍体造血干细胞移植是可行的,尤其对于找不到同胞相合及无关全相合供者的患者来说,HLA单倍体相合的血缘关系亲属成为最有潜力的干细胞来源。减低剂量预处理的单倍体造血干细胞移植保留较强的移植物抗白血病效应,且寻找供者容易,有足够的细胞后续治疗如供者淋巴细胞输注,同时通过发挥移植物抗白血病效应,可有效清除患者体内的肿瘤细胞,为处在疾病进展期或经历多次治疗失败的患者,尤其是老年患者、合并器官功能障碍及并发症患者,提供有效的挽救治疗手段。但由于开展的时间较短,今后在应用中该如何选择最佳方案、最佳时机以及减低移植物抗宿主病、移植相关死亡率及复发率等尚需进一步深入的研究。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

异基因造血干细胞移植治疗24例重型再生障碍性贫血北大核心

背景:重型再生障碍性贫血病情重、病死率高,需快速恢复造血功能,目前异基因造血干细胞移植为一线治疗方案,同胞全相合异基因造血干细胞移植为首选,单倍体相合造血干细胞移植作为替代治疗方案也取得了较好的效果。目的:探讨异基因造血干细胞移植(包括同胞全相合造血干细胞移植及单倍体相合造血干细胞移植)治疗重型再生障碍性贫血的临床疗效。方法:回顾性分析2015年4月至2021年7月于徐州市中心医院接受异基因造血干细胞移植治疗24例重型再生障碍性贫血患者的临床资料,其中接受同胞全相合造血干细胞移植8例,接受单倍体相合造血干细胞移植16例。24例重型再生障碍性贫血患者预处理方案为氟达拉滨、环磷酰胺、抗淋巴细胞球蛋白方案。同胞全相合造血干细胞移植采用环孢素联合短程甲氨蝶呤预防移植物抗宿主病,单倍体相合造血干细胞移植在此基础上增加吗替麦考酚酯。结果与结论:①24例重型再生障碍性贫血患者中有2例患者预处理期间死于严重感染,其余22例均达造血重建;中性粒细胞植入中位时间为12.5(10-18)d,血小板植入中位时间为14.5(10-26)d;②22例植入成功患者发生急性移植物抗宿主病8例(36%),Ⅲ/Ⅳ度急性移植物抗宿主病2例,慢性移植物抗宿主病累计发生4例(18%),Ⅲ/Ⅳ度慢性移植物抗宿主病1例;③18例患者存活,6例患者死亡,5年预计总生存率为74%;④结果表明,异基因造血干细胞移植为重型再生障碍性贫血的有效治疗手段,同胞全合供者作为首选,无同胞全相合供者时可选择单倍体相合供者作为替代。     

Complications of haematopoietic stem cell transplantation

Allogeneic haematopoietic stem cell transplantation (HSCT) following myeloablative conventional conditioning regimen is associated with a higher incidence of transplant-related morbidity and mortality, limiting its applicability to younger patients without significant co-morbidities. The morbidity and mortality of HSCT are related closely to relapse of malignancy, conditioning-related toxicities, infection, and donor–recipient human leucocyte antigen (HLA) disparity. Disparities at minor histocompatibility antigens are thought to be responsible for acute graft-versus-host disease in patients receiving HSCT from a HLA-matched donor. Serious complications tend to erupt within specified periods of immunologic reconstitution after bone marrow grafting. Because their innate and acquired immune systems are especially vulnerable, HSCT recipients often have infectious and noninfectious complications. This article reviews the major complications of HSCT.     

HLA单倍体相合与全相合外周血造血干细胞移植后的急性移植物抗宿主病

背景：异基因外周血造血干细胞移植成为造血干细胞移植的主要方式,近年来HLA单倍体相合造血干细胞移植因供者来源广泛在临床应用较多,急性移植物抗宿主病仍是影响移植成功率的主要因素。 目的：观察亲缘HLA单倍体相合与全相合异基因外周血造血干细胞移植后急性移植物抗宿主病的发生特点,探讨降低急性移植物抗宿主病发生率的方法及单倍体造血干细胞移植应用于临床的意义。 方法：行异基因外周血造血干细胞移植的患者52例,其中HLA全相合组31例,单倍体组21例。HLA单倍体组采用改良马利兰/环磷酰胺+兔抗人胸腺T细胞免疫球蛋白预处理方案,HLA全相合组采用改良马利兰/环磷酰胺预处理方案。移植物抗宿主病的预防采用短程甲氨蝶呤+环孢素A+吗替麦考酚酯的方案。 结果与结论：52例患者均获得完全持久干细胞植入。其中,急性移植物抗宿主病发病率为48%(25/52),Ⅲ-Ⅳ度急性移植物抗宿主病发病率为23%(12/52);全相合组及单倍体组急性移植物抗宿主病累积发病率分别为39%(12/31)和62%(13/21)(P > 0.05);全相合组及单倍体组Ⅲ-Ⅳ度急性移植物抗宿主病累积发病率分别为10%(3/31)和43%(9/21)(P < 0.05);发生于移植后+30 d、+31 d-+60 d、+61 d-+100 d的急性移植物抗宿主病类型分布差异无显著性意义(P > 0.05);发生在移植后+30 d内的急性移植物抗宿主病发生率高于移植后   +31 d-+60 d和+61 d-+100 d;发生急性移植物抗宿主病组和无急性移植物抗宿主病组复发率、2年无病生存率差异无显著性意义(P > 0.05),全相合组与单倍体组相比复发率差异无显著性意义(P > 0.05),2年无病生存率前者高于后者(P < 0.05)。说明采用上述移植方案,单倍体组安全性与疗效接近全相合组;在缺乏HLA相合供者时,单倍体造血干细胞移植是治疗恶性血液病的重要方法。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

Unmanipulated HLA 2-3 antigen-mismatched (haploidentical) stem cell transplantation using nonmyeloablative conditioning.

The major problems in human leukocyte antigen (HLA)-mismatched stem cell transplantation (SCT) are graft failure and graft-versus-host disease (GVHD). Less-intensive regimens should be associated with a lower release of inflammatory cytokines and possibly less GVHD. The objective of this study was to investigate whether HLA-haploidentical SCT can be performed using nonmyeloablative conditioning and pharmacologic GVHD prophylaxis, including glucocorticoids. Using conditioning consisting of fludarabine, busulfan, and anti-T-lymphocyte globulin and GVHD prophylaxis consisting of tacrolimus and methylprednisolone (1 mg/kg/day), 26 patients who had hematologic malignancies in an advanced stage or with a poor prognosis underwent transplantation using peripheral blood stem cells from an HLA-haploidentical donor (2-3 antigen mismatches in the graft-versus-host [GVH] direction) without T-cell depletion. All patients except for 1 achieved donor-type engraftment. Rapid hematologic engraftment was achieved (neutrophils > 0.5 x 10(9)/L on day 12 and platelets > 20 x 10(9)/L on day 12), with full donor chimerism achieved by day 14. Fifteen patients did not develop acute GVHD clinically, and only 5 patients developed grade II GVHD. The recovery of CD4+ T cells was delayed compared with that of CD8+ T cells. Sixteen of the 26 patients are alive in complete remission. Four died of transplantation-related causes, and 6 died of progressive disease. These data suggest that nonmyeloablative conditioning, GVHD prophylaxis consisting of tacrolimus and methylprednisolone, and early therapeutic intervention for the GVH reaction allow stable engraftment and effectively suppress GVHD in HLA 2-3 antigen-mismatched SCT.     

Risk factors for herpes simplex virus-1/2 viremia and clinical outcomes following unmanipulated haploidentical haematopoietic stem cell transplantation

BackgroundHerpes simplex virus (HSV)-1/2 can still be reactivated after allogeneic haematopoietic stem cell transplantation (allo-HSCT) even when the prophylactic acyclovir is used. However, the risk factors for HSV-1/2 viremia and the clinical outcomes following unmanipulated haploidentical HSCT remain unknown.Objectives and study designNineteen patients with HSV-1/2 viremia and fifty-seven patients without HSV-1/2 viremia which were selected using the case-pair method after undergoing haploidentical HSCT were enrolled. We analysed the risk factors for HSV-1/2 viremia and compared the clinical outcomes between the two groups.ResultsThe risk factors for HSV-1/2 viremia included HLA disparity ≥2 loci (p = 0.049) and cytomegalovirus (CMV) reactivation (p = 0.028). The incidences of platelet engraftment, oral mucositis and severe haemorrhagic cystitis (HC) in patients with and without HSV-1/2 viremia were 77% and 94% (p = 0.003), 78% and 13% (p = 0.000), and 25% and 6% (p = 0.04), respectively. Moreover, the median time to platelet engraftment in patients with and without HSV-1/2 viremia was +25 days (range, +11–+80) and +17 days (range, +8–+67) (p = 0.004), respectively. According to the multivariate analyses, HSV-1/2 viremia was associated with delayed platelet engraftment (p = 0.038), a higher incidence of oral mucositis (p = 0.000) and severe HC (p = 0.038). However, HSV-1/2 viremia was not associated with non-relapse mortality (34.0% vs. 31.5%, p = 0.26), leukaemia-free survival (60.9% vs. 57.9%, p = 0.46) and overall survival (61.2% vs. 60.7%, p = 0.37).ConclusionsBased on our study results, we recommend that HSV-1/2 PCR should be performed upon clinical suspicion of HSV-1/2 infection.     

Red cell transfusion thresholds in haematopoietic stem cell transplantation

Red cell transfusions are part of the routine supportive care following haematopoietic stem cell transplantation. There is increasing evidence from randomized controlled trials demonstrating that restrictive transfusion thresholds are equivalent to liberal thresholds in other patient populations. However, given the lack of patient‐centred outcomes and the longer transfusion support required for patients with haematologic malignancies, the results of these trials may not be generalizable to haematology–oncology patients. In the recently completed multicentre TRIST trial, we randomized 300 patients requiring an autologous or allogeneic haematopoietic stem cell transplantation to either a restrictive (haemoglobin threshold <70 g/l) or liberal (haemoglobin threshold <90 g/l) red cell transfusion strategy. Our primary outcome was health‐related quality of life measured by FACT‐BMT through day 100 post‐transplant. The median number of red cell units transfused was lower in the restrictive strategy group (2 vs. 4). The FACT‐BMT total score was higher at all time points for patients in the restrictive transfusion group including at baseline (109 vs. 103) and at 100 days (116·3 vs. 109·2). After adjustment for baseline, the FACT‐BMT score at day 100 in the restrictive group was statistically non‐inferior to the liberal group (P < 0·0001). There were no significant differences between the two groups for any other clinical outcomes. Based on the results of the TRIST trial, a restrictive haemoglobin threshold of 70 g/l should become standard practice in haematopoietic stem cell transplant patients, and, given the lack of other clinical studies, all other haematology–oncology inpatients.     

父母供子女单倍型造血干细胞移植治疗恶性血液病

背景：单倍型造血干细胞移植是治疗恶性血液病的一种有效方法,合适的供者及快速查找到合适的供者有助于提高移植的成功率。 目的：比较父母供子女单倍型造血干细胞移植治疗恶性血液病的临床疗效。 方法：对郑州大学第一附属医院92例恶性血液病患者行父母为供者的单倍型造血干细胞移植治疗,分为父供子移植、父供女移植、母供子移植、母供女移植4组,对比4组患者移植物抗宿主病的发生率、复发率、2年无病生存率及总生存率等。 结果与结论：92例患者均完全植入并获得造血重建,4组急性移植物抗宿主病发生率、慢性移植物抗宿主病发生率和复发率差异无显著性意义(P > 0.05)。但4组Ⅲ、Ⅳ度急性移植物抗宿主病发生率、2年无病生存率、2年总生存率差异有显著性意义(P < 0.05)。其中父供子移植组、母供女移植组的Ⅲ、Ⅳ度急性移植物抗宿主病发生率低于父供女移植组和母供子移植组;同时父供子移植组和母供女移植组的2年无病生存率、2年总生存率高于父供女移植组和母供子移植组。可见父母供子女单倍型造血干细胞移植是安全可行的,供受者性别相同比供受者性别不同的疗效好。     

Predicted indirectly recognizable HLA epitopes are not associated with clinical outcomes after haploidentical hematopoietic stem cell transplantation

Haploidentical stem cell transplantation (haplo-SCT) provides an alternative method to cure patients with malignant and nonmalignant hematologic diseases who lack a human leukocyte antigen (HLA) matched related or unrelated donor. HLA disparity between donor and patient was the main reason causing lots of clinical immune response. The aim of this study was to investigate whether indirect recognition of mismatched HLA could predict the clinical outcomes in haplo-SCT. The probability of indirect recognition was predicted by the Predicted Indirectly ReCognizable HLA Epitopes (PIRCHE) model. 577 patients with acute leukemia or myelodysplastic syndrome receiving haplo-SCT were enrolled in the study. Patients were divided into 4 quartiles according to PIRCHE-Ⅰ or PIRCHE-Ⅱ. Although the cumulative incidences of chronic graft-versus-host disease (GVHD) were significantly different among the 4 PIRCHE-Ⅰgroups, with 20.4% for group 0–6, 40.5% for group >6–11, 26.1% for group >11–19 and 23.9% for group >19 (P?=?.007), PIRCHE-Ⅰ was not significantly associated with chronic GVHD in multivariate models (RR, 0.993; 95% CI, 0.858–1.149; P?=?.926). And no significant associations were observed between PIRCHE-Ⅰ or PIRCHE-Ⅱ and other clinical outcomes. In summary, PIRCHE did not correlate with clinical outcomes and could not predict haplo-SCT outcomes.