Tang Baolin, Zhu Xiaoyu, Zheng Changcheng, Liu Huilan, Hao Siguo, Huang Dongping, Lin Dongjun, Li Nainong, Gao Sujun, Liang Xinquan, Li Jianjun, Huang Lulu, Geng Liangquan, Ding Kaiyang, Wang Xingbing, Yao Wen, Song Kaidi, Zhang Xuhan, Wan Xiang, Zhang Lei, Tong Juan, Sun Guangyu, Wei Zhonglin, Liu Xiaoliang, Wu Yun, Sun Zimin
Shandong University School of Medicine, Jinan, China.
Department of Haematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Bone Marrow Transplant. 2019 Oct;54(10):1614-1624. doi: 10.1038/s41409-019-0441-4. Epub 2019 Feb 25.
Limited to inadequate stem-cell doses, cord blood transplantation (UCBT) is accompanied by increased graft failure and delayed haematopoietic recovery. The conditioning regimen is critically important for engraftment, and numerous trials have been undertaken comparing the outcomes of IV Bu and TBI, but there are no comparative data for UCBT. We conducted a retrospective multicentre study to analyse the outcomes of IV Bu and TBI in UCBT patients with haematologic malignancies. Between 1 May, 2008 and 31 Mar, 31 2018, a total of 331 patients from the China Umbilical Cord Blood Transplantation Corporation (IV Bu, n = 131; TBI, n = 200) were evaluated. The cumulative incidence of neutrophil engraftment was 91.6% in the IV Bu/Cy cohort and 98.0% in the Cy/TBI cohort (P < 0.001). The median times to neutrophil engraftment were 16 and 19 days (P < 0.001), respectively. Multivariate analysis showed no statistical difference for nonrelapse mortality (hazard ratio [HR], 1.11; 95% confidence interval [CI], 0.66 to 1.86; P = 0.695), relapse (HR, 0.90; 95% CI, 0.50 to 1.60; P = 0.713) and overall survival (HR, 0.94; 95% CI, 0.61 to 1.44; P = 0.763) between the two conditioning regimens. Our results show that both IV Bu and TBI are valid myeloablative conditioning regimens for haematologic malignancy patients treated with UCBT.
限于干细胞剂量不足，脐带血移植（UCBT）会出现移植失败增加和造血恢复延迟的情况。预处理方案对于植入至关重要，已经进行了许多试验比较静脉注射白消安（IV Bu）和全身照射（TBI）的结果，但尚无UCBT的比较数据。我们进行了一项回顾性多中心研究，以分析血液系统恶性肿瘤的UCBT患者中IV Bu和TBI的结果。在2008年5月1日至2018年3月31日期间，对来自中国脐带血移植公司的331例患者（IV Bu组，n = 131；TBI组，n = 200）进行了评估。IV Bu/Cy队列中性粒细胞植入的累积发生率为91.6%，Cy/TBI队列为98.0%（P < 0.001）。中性粒细胞植入的中位时间分别为16天和19天（P < 0.001）。多变量分析显示，两种预处理方案在非复发死亡率（风险比[HR]，1.11；95%置信区间[CI]，0.66至1.86；P = 0.695）、复发率（HR，0.90；95%CI，0.50至1.60；P = 0.713）和总生存率（HR，0.94；95%CI，0.61至1.44；P = 0.763）方面无统计学差异。我们的结果表明，IV Bu和TBI都是用于接受UCBT治疗的血液系统恶性肿瘤患者的有效的清髓性预处理方案。
