Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Hematology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, China.
Transplant Cell Ther. 2022 Dec;28(12):849.e1-849.e8. doi: 10.1016/j.jtct.2022.08.025. Epub 2022 Aug 29.
To compare the outcomes between peripheral blood stem cell (PBSC)+cord blood and PBSC+bone marrow (BM) grafts in the setting of haploidentical donor (HID) transplantation, 110 patients were enrolled in this retrospective study, including 54 recipients of haplo-PBSC+cord transplants and 56 recipients of haplo-PBSC+BM transplants. Chimerism analyses revealed that by day 30 post-transplantation, 94.3% of surviving patients in the haplo-PBSC+cord group had achieved full haploidentical chimerism and 5.7% had <10% cord chimerism, whereas 100% of surviving patients in the haplo-PBSC+BM group had achieved full donor chimerism. The cumulative incidence of platelet engraftment at 30 days was 92.6% in the haplo-PBSC+cord group versus 89.3% in the haplo-PBSC+BM group (P =.024), that of grade II-IV acute graft-versus-host disease (GVHD) at 100 days was 31.5% versus 48.2% (P =.060), and 1-year relapse was 13.0% versus 25.0% (P =.027), nonrelapse mortality was 9.3% versus 12.5% (P =.76), disease-free survival (DFS) was 77.7% versus 62.5% (P =.028), and overall survival (OS) was 81.4% versus 69.6% (P =.046). Multivariate analysis identified haplo-PBSC+cord transplantation as a protective factor for relapse (hazard ratio [HR], .31; P =.007), DFS (HR, .40; P =.007), and OS (HR, .44; P =.016). Overall, haplo-PBSC+cord transplantation led to faster platelet engraftment, lower relapse, and superior DFS and OS compared with haplo-PBSC+BM transplantation and thus might be a better transplant mode in the setting of HID transplantation.
为了比较单倍体供者外周血造血干细胞（PBSC）+脐带血与 PBSC+骨髓（BM）移植在单倍体供者移植中的疗效，本回顾性研究纳入了 110 例患者，其中 54 例接受了单倍体 PBSC+脐带血移植，56 例接受了单倍体 PBSC+BM 移植。嵌合状态分析显示，移植后第 30 天，单倍体 PBSC+脐带血移植组 94.3%的存活患者达到完全单倍体嵌合，5.7%的患者脐带血嵌合率<10%，而单倍体 PBSC+BM 移植组 100%的存活患者均达到完全供者嵌合。单倍体 PBSC+脐带血移植组 30 天血小板植入的累积发生率为 92.6%，而单倍体 PBSC+BM 移植组为 89.3%（P=.024）；100 天Ⅱ-Ⅳ级急性移植物抗宿主病（GVHD）的累积发生率为 31.5%比 48.2%（P=.060）；1 年复发率为 13.0%比 25.0%（P=.027）；非复发死亡率为 9.3%比 12.5%（P=.76）；无病生存（DFS）率为 77.7%比 62.5%（P=.028）；总生存（OS）率为 81.4%比 69.6%（P=.046）。多因素分析显示，单倍体 PBSC+脐带血移植是复发（风险比[HR]，.31；P=.007）、DFS（HR，.40；P=.007）和 OS（HR，.44；P=.016）的保护因素。总体而言，与单倍体 PBSC+BM 移植相比，单倍体 PBSC+脐带血移植可更快地实现血小板植入，降低复发率，并改善 DFS 和 OS，因此可能是单倍体供者移植的更好选择。
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