Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Diseases (Xiangya Hospital), Changsha, China.
Front Immunol. 2022 Sep 2;13:980464. doi: 10.3389/fimmu.2022.980464. eCollection 2022.
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.
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。