Cheng Tingting, Chen Yan, Liu Yi, Ma Xia, Zeng Cong, Chen Xu, Wang Shiyu, Xu Yajing
Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Diseases, (Xiangya Hospital), Changsha, China.
Front Oncol. 2022 Jul 14;12:922120. doi: 10.3389/fonc.2022.922120. eCollection 2022.
Recent studies have shown that haploidentical hematopoietic stem cell transplantation supported by third-party cord blood (haplo-cord-HSCT) results in rapid hematopoietic recovery, low incidences of graft-versus-host disease (GVHD), and relapse of hematologic malignancies. However, few reports on haploidentical peripheral blood stem cell transplantation supported by third-party cord blood (haplo-cord-PBSCT) have been published. To evaluate the outcomes of patients who underwent haplo-cord-PBSCT or human leukocyte antigen (HLA)-matched sibling donor peripheral blood stem cell transplantation (MSD-PBSCT), we retrospectively reviewed the clinical data of patients with hematologic malignancies who underwent haplo-cord-PBSCT (n = 93) or MSD-PBSCT (n = 72) in our hospital from March 2017 to December 2020. In the haplo-cord-PBSCT and MSD-PBSCT groups, the median time for neutrophil and platelet engraftment was 13 vs. 12 days ( = 0.07) and 16 vs. 13 days ( = 0.06), respectively. The 30-day cumulative incidences of neutrophil engraftment were 100.0% and 98.6% ( = 0.12). The 100-day cumulative incidences of platelet engraftment were 96.8% and 98.6% ( = 0.01). The 100-day cumulative incidences of grade II-IV and grade III-IV acute GVHD were 29.1% vs. 23.6% ( = 0.42) and 9.7% vs. 4.2% ( = 0.18). The cumulative incidences of total and moderate/severe chronic GVHD at 1 year were 26.5% vs. 17.4% and 8.1% vs. 4.5%, respectively, and at 3 years were 34.7% vs. 34.3% ( = 0.60) and 13.6% vs. 10.6% ( = 0.49), respectively. The cumulative incidences of relapse at 1 year were 9.3% and 7.2% and at 3 years were 17.0% and 17.0% ( = 0.98). Non-relapse mortality (NRM) at 1 year was 14.6% and 8.6% and at 3 years was 17.4% and 8.6% ( = 0.13) in two groups. The probabilities of overall survival (OS), disease-free survival (DFS), and GVHD-free/relapse-free survival (GRFS) at 1 year were 81.7% vs. 88.6%, 76.1% vs. 84.2%, and 71.7% vs. 79.7%, respectively, and at 3 years were 78.7% vs. 79.0%, 65.6% vs. 74.4%, and 55.5% vs. 63.6%, respectively, in the corresponding group, > 0.05. In conclusion, for patients with acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) and acute lymphoid leukemia (ALL), haplo-cord-PBSCT results in similar outcomes compared with MSD-PBSCT, and it may be a valid alternative transplantation method.
近期研究表明，第三方脐带血支持的单倍体造血干细胞移植（haplo-cord-HSCT）可使造血功能快速恢复，移植物抗宿主病（GVHD）及血液系统恶性肿瘤复发的发生率较低。然而，关于第三方脐带血支持的单倍体外周血干细胞移植（haplo-cord-PBSCT）的报道较少。为评估接受haplo-cord-PBSCT或人类白细胞抗原（HLA）匹配的同胞供体外周血干细胞移植（MSD-PBSCT）患者的治疗效果，我们回顾性分析了2017年3月至2020年12月在我院接受haplo-cord-PBSCT（n = 93）或MSD-PBSCT（n = 72）治疗的血液系统恶性肿瘤患者的临床资料。在haplo-cord-PBSCT组和MSD-PBSCT组中，中性粒细胞和血小板植入的中位时间分别为13天对12天（P = 0.07）和16天对13天（P = 0.06）。中性粒细胞植入的30天累积发生率分别为100.0%和98.6%（P = 0.12）。血小板植入的100天累积发生率分别为96.8%和98.6%（P = 0.01）。II-IV级和III-IV级急性GVHD的100天累积发生率分别为29.1%对23.6%（P = 0.42）和9.7%对4.2%（P = 0.18）。1年时慢性GVHD总发生率及中/重度慢性GVHD累积发生率分别为26.5%对17.4%和8.1%对4.5%，3年时分别为34.7%对34.3%（P = （此处原文有误，推测应为P = 0.60））和13.6%对10.6%（P = 0.49）。1年时复发的累积发生率分别为9.3%和7.2%，3年时分别为17.0%和17.0%（P = 0.98）。两组1年时非复发死亡率（NRM）分别为14.6%和8.6%，3年时分别为17.
