Department of Hematology, the Affiliated DrumTower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing 210008, PR China.
Leuk Res. 2010 Aug;34(8):1018-22. doi: 10.1016/j.leukres.2009.11.020. Epub 2009 Dec 23.
The effect of unrelated donor bone marrow transplantation (UBMT) and unrelated donor cord blood transplantation (UCBT) on the outcome of patients with hematological diseases remains controversial. We conducted a meta-analysis using data from controlled clinical trials comparing UCBT to UBMT in patients undergoing hematopoietic stem cell transplantation. Pooled comparisons of studies of UCBT and UBMT in children found that the incidence of chronic graft-versus-host disease (GVHD) was lower with UCBT (relative risk [RR]=0.41; 95% confidence interval [CI] (0.25, 0.68)), and the incidence of grades II-IV aGVHD was also significantly different (RR=0.69; 95% CI (0.55, 0.86)). The incidence of relapse was also lower with UCBT (RR=0.72; 95% CI (0.59, 0.87)). There was no difference in OS in children when studies were pooled (Hazard ratio [HR]=1.25; 95% CI (0.87, 1.78)). For adults, OS (HR=1.26; 95% CI (1.13, 1.40)) was statistically different. Thus, UCBT led to inferior outcomes than UBMT in adults.
无关供者骨髓移植（UBMT）和无关供者脐血移植（UCBT）对血液病患者结局的影响仍存在争议。我们使用来自比较造血干细胞移植中 UCBT 与 UBMT 的对照临床试验数据进行了荟萃分析。对 UCBT 和 UBMT 在儿童患者中的研究进行的汇总比较发现，UCBT 组慢性移植物抗宿主病（GVHD）的发生率较低（相对风险 [RR]=0.41；95%置信区间 [CI]（0.25，0.68）），且 2-4 级急性 GVHD 的发生率也有显著差异（RR=0.69；95% CI（0.55，0.86））。UCBT 组的复发率也较低（RR=0.72；95% CI（0.59，0.87））。当汇总研究时，儿童患者的 OS 无差异（风险比 [HR]=1.25；95% CI（0.87，1.78））。对于成人，OS（HR=1.26；95% CI（1.13，1.40））存在统计学差异。因此，UCBT 导致成人患者的结局劣于 UBMT。
