Sun Zimin, Hu Yu, Ji Yanping, Liu Xueou, Gong Xiaowen, Feng Yahui, Liu Huilan, Zhang Wei, Qi Saibing, Shen Qiujin, Song Kaidi, Geng Liangquan, Yao Wen, Wan Xiang, Tang Baolin, Zhu Xiaoyu, Sun Guangyu, Qiang Ping, Song Zhen, Chen Junren
Department of Hematology The First Affiliated Hospital of University of Science and Technology of China Hefei China.
Blood and Cell Therapy Institute Division of Life Sciences and Medicine Anhui Provincial Key Laboratory of Blood Research and Applications University of Science and Technology of China Hefei China.
EJHaem. 2023 Apr 25;4(2):470-475. doi: 10.1002/jha2.703. eCollection 2023 May.
The algorithm for cord blood (CB) unit selection is still somewhat ambiguous. We retrospectively analyzed 620 cases of acute leukemia between 2015 and 2020, who were treated with myeloablative single-unit umbilical CB transplantation (UCBT). We found that, when human leukocyte antigen (HLA) mismatch was ≤3/10, CD34 cell dosage <0.83 × 10/kg-considerably lower than prevalent guidelines-was permissible without affecting survival. Moreover, synergy between donor killer-cell immunoglobulin-like receptors (KIR) haplotypes-B and donor-recipient HLA-C mismatch protected against relapse-related mortality. We submit that minimum required CD34 cell dosage can possibly be relaxed to broaden access to UCBT, and donor KIR genotyping should be considered during unit selection.
脐带血（CB）单位选择算法仍有些模糊不清。我们回顾性分析了2015年至2020年间接受清髓性单单位脐血移植（UCBT）治疗的620例急性白血病患者。我们发现，当人类白细胞抗原（HLA）错配≤3/10时，CD34细胞剂量<0.83×10⁶/kg（远低于现行指南）在不影响生存率的情况下是允许的。此外，供体杀伤细胞免疫球蛋白样受体（KIR）单倍型B与供体-受体HLA-C错配之间的协同作用可预防复发相关死亡率。我们认为，可能可以放宽所需的最低CD34细胞剂量，以扩大UCBT的可及性，并且在单位选择过程中应考虑供体KIR基因分型。
