Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Bone Marrow Transplant. 2010 Oct;45(10):1508-13. doi: 10.1038/bmt.2009.378. Epub 2010 Feb 1.
From January 1991 to March 2007, 61 children and adolescent with acquired severe aplastic anemia received BMT in our institutions. We retrospectively compared the outcome of 30 cases of matched-sibling donor BMT (MSD-BMT) and 31 cases of unrelated donor BMT (URD-BMT). We observed one graft failure among MSD-BMT recipients and three graft failures among URD-BMT recipients, respectively. No patients in the MSD-BMT group developed grades II-IV acute GVHD compared with 11 of 30 patients (37%) in the URD-BMT group (P<0.001). One of 30 MSD-BMT recipients (3%) developed chronic GVHD compared with 8 of 30 URD-BMT recipients (27%) (P=0.013). The incidence of EBV and CMV reactivation was 11 of 20 URD-BMT recipients and 23 of 30, respectively. One patient in the URD-BMT group died of a motor accident 5.5 years after BMT. Ten-year OS was 100% in MSD-BMT recipients and 93.8% (95% CI, 81.9-100%) in URD-BMT recipients, respectively (P=0.252). Ten-year failure-free survival was 96.7% (95% CI, 90.2-100%) in the MSD-BMT group and 84.7% (95% CI, 70.2-99.2%) in the URD-BMT group, respectively (P=0.161).
从 1991 年 1 月至 2007 年 3 月，我们机构收治了 61 例获得性严重再生障碍性贫血的儿童和青少年患者，他们接受了 BMT。我们回顾性地比较了 30 例匹配同胞供者 BMT（MSD-BMT）和 31 例无关供者 BMT（URD-BMT）患者的结果。我们观察到 MSD-BMT 受者中有 1 例移植物失败，URD-BMT 受者中有 3 例移植物失败。MSD-BMT 组无患者发生 II-IV 级急性移植物抗宿主病，而 URD-BMT 组中有 30 例患者中的 11 例（37%）（P<0.001）。MSD-BMT 组中有 1 例（3%）患者发生慢性移植物抗宿主病，而 URD-BMT 组中有 30 例患者中的 8 例（27%）（P=0.013）。URD-BMT 组中有 20 例患者中的 11 例和 30 例患者中的 23 例发生 EBV 和 CMV 再激活。URD-BMT 组中有 1 例患者在 BMT 后 5.5 年死于车祸。MSD-BMT 受者的 10 年 OS 为 100%，URD-BMT 受者为 93.8%（95%CI，81.9-100%）（P=0.252）。MSD-BMT 组的 10 年无失败生存率为 96.7%（95%CI，90.2-100%），URD-BMT 组为 84.7%（95%CI，70.2-99.2%）（P=0.161）。
