Wang Ying, Chen Feng, Han Yue, Fu Zheng-Zheng, Tang Xiao-Wen, Miao Miao, Qiu Hui-Ying, Jin Zheng-Ming, Sun Ai-Ning, Wu De-Pei
Department of Hematology, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
Biol Blood Marrow Transplant. 2009 Oct;15(10):1258-64. doi: 10.1016/j.bbmt.2009.05.020. Epub 2009 Jul 25.
The optimal alternative donor for adult hematopoietic stem cell transplantation (HSCT) candidates who lack an ideal histocompatible sibling remains controversial. We studied the clinical outcomes of 88 adult patients with hematologic malignancies who received a partially matched related donor (PMRD) transplant (n=36) or a matched unrelated donor (MUD) transplant (n=52) with a uniform myeloablative protocol without ex vivo T cell depletion. Age and other characteristics were comparable in the 2 groups, except that the PMRD group had a higher proportion of bone marrow (BM) grafts. Primary engraftment was achieved in nearly 98% of the whole cohort. The incidences of acute grade III-IV and extensive chronic graft-versus-host disease (aGVHD, cGVHD) were 15% and 16% in the PMRD group and 16% and 14% in the MUD group. Although treatment-related mortality (TRM) was 42% in the PMRD group and 31% in the MUD group (P=.29), the relapse rate was<11% for the whole cohort. With a median follow-up of 30 months, no statistically significant difference was observed in 3-year overall survival (OS) and event-free survival (EFS) between the PMRD group (45% and 38%) and the MUD group (54% and 50%). These data demonstrate that HSCT performed with PMRD can be an alternative option for treating adult patients with hematologic malignancies.
对于缺乏理想的组织相容性同胞供者的成人造血干细胞移植(HSCT)候选者而言,最佳的替代供者仍存在争议。我们研究了88例患有血液系统恶性肿瘤的成人患者的临床结局,这些患者接受了部分匹配的相关供者(PMRD)移植(n = 36)或匹配的无关供者(MUD)移植(n = 52),采用统一的清髓方案且未进行体外T细胞去除。两组患者的年龄和其他特征具有可比性,只是PMRD组的骨髓(BM)移植物比例更高。整个队列中近98%的患者实现了初次植入。PMRD组急性III-IV级和广泛慢性移植物抗宿主病(aGVHD、cGVHD)的发生率分别为15%和16%,MUD组分别为16%和14%。尽管PMRD组的治疗相关死亡率(TRM)为42%,MUD组为31%(P = 0.29),但整个队列的复发率<11%。中位随访30个月,PMRD组(45%和38%)与MUD组(54%和50%)之间在3年总生存(OS)和无事件生存(EFS)方面未观察到统计学上的显著差异。这些数据表明,采用PMRD进行HSCT可以作为治疗成人血液系统恶性肿瘤患者的一种替代选择。