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Haploidentical 外周血造血干细胞移植联合无关脐带血在血液恶性肿瘤患者中的应用:80 例报告。

Haploidentical peripheral blood stem cell transplantation combined with unrelated cord blood in hematologic malignancy patients: A report of 80 cases.

机构信息

Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.

National Clinical Research Center for Geriatric Diseases (Xiangya Hospital), Changsha, China.

出版信息

Front Immunol. 2022 Sep 2;13:980464. doi: 10.3389/fimmu.2022.980464. eCollection 2022.

Abstract

The outcomes of 80 patients with hematologic malignancies who received haploidentical peripheral blood stem cell transplantation (haplo-PBSCT) combined with unrelated cord blood (UCB) from March 2017 to June 2020 were analyzed in this retrospective study. Anti-thymocyte globulin(ATG) was administered at a dose of 7.5 mg/kg. The median time for neutrophil and platelet engraftment was 13(range: 8-22) days and 14(range: 8-103) days, respectively. The 30-day cumulative incidence of neutrophil engraftment was 100%, and the 100-day cumulative incidence of platelet engraftment was 95%. All patients achieved complete haploidentical peripheral blood stem cell engraftment, and no cord blood chimerism was observed. The cumulative incidence of grades II-IV and grades III-IV acute graft-versus-host disease (aGVHD) on 100-day was 26.3%(95%CI: 17.2%-36.3%) and 5.0%(95%CI: 1.6%-11.4%), respectively. The estimated cumulative incidence of chronic GVHD (cGVHD) and moderate-severe cGVHD at 3-year was 43.3%(95%CI: 31.6%-54.4%) and 16.0%(95%CI: 8.7%-25.2%), respectively. The estimated 3-year cumulative incidence of relapse and non-relapse mortality was 18.8%(95%CI: 10.0%-29.7%) and 17.8%(95%CI: 9.9%-27.5%), respectively. The estimated 3-year probabilities of overall survival, disease-free survival, GVHD/relapse-free survival were 77.6%(95%CI: 68.3%-88.1%), 63.4%(95%CI: 52.6%-76.5%), and 55.5%(95%CI: 44.8%-68.7%), respectively. These satisfying results suggested that haplo-PBSCT combined with UCB is an alternative transplantation protocol for hematologic malignancies.

摘要

本回顾性研究分析了 2017 年 3 月至 2020 年 6 月 80 例接受单倍体外周血造血干细胞移植(haplo-PBSCT)联合无关脐带血(UCB)的血液系统恶性肿瘤患者的结果。给予抗胸腺细胞球蛋白(ATG)7.5mg/kg。中性粒细胞和血小板植入的中位时间分别为 13(范围:8-22)天和 14(范围:8-103)天。中性粒细胞植入的 30 天累积发生率为 100%,血小板植入的 100 天累积发生率为 95%。所有患者均实现完全单倍体外周血造血干细胞植入,未观察到脐带血嵌合体。100 天Ⅱ-Ⅳ级和Ⅲ-Ⅳ级急性移植物抗宿主病(aGVHD)的累积发生率分别为 26.3%(95%CI:17.2%-36.3%)和 5.0%(95%CI:1.6%-11.4%)。3 年慢性移植物抗宿主病(cGVHD)和中重度 cGVHD 的估计累积发生率分别为 43.3%(95%CI:31.6%-54.4%)和 16.0%(95%CI:8.7%-25.2%)。3 年复发和非复发死亡率的估计累积发生率分别为 18.8%(95%CI:10.0%-29.7%)和 17.8%(95%CI:9.9%-27.5%)。3 年总生存率、无病生存率、GVHD/复发无生存率的估计概率分别为 77.6%(95%CI:68.3%-88.1%)、63.4%(95%CI:52.6%-76.5%)和 55.5%(95%CI:44.8%-68.7%)。这些令人满意的结果表明,haplo-PBSCT 联合 UCB 是血液系统恶性肿瘤的一种替代移植方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/190a/9478412/cddb4a85c911/fimmu-13-980464-g001.jpg

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