Division of Hematology and Cell Therapy, UH Seidman Cancer Center and Case Western Comprehensive Cancer Center, Cleveland, OH, USA.
Stem Cell Transplant Program, Weill Cornell Medical School and New York Presbyterian Hospital, New York City, NY, USA.
Leuk Lymphoma. 2024 Oct;65(10):1384-1397. doi: 10.1080/10428194.2024.2361353. Epub 2024 Jul 1.
The combination of cord blood transplant with progenitor cells from partially HLA-matched adult donors has been used over the past two decades. In Europe and the US the adult donor graft is CD34 selected and provides early hematopoiesis, but durable engraftment derives from the cord blood graft . Neutrophil recovery is prompt and rates of acute and chronic GVHD are low. Recent Chinese studies combine cord blood grafts with T-replete haplo-identical grafts . The haplo graft usually establishes dominance and UCB chimerism is rarely detected. Comparison studies suggest considerably decreased rates of relapse and improved outcomes, compared with either haplo-identical transplant or CBU transplant, particularly in patients with advanced leukemia. A recent prospective randomized study confirms this. Haplo-cord mitigates the engraftment delay of UCB transplant. The unique biology of UCB grafts results in low GVHD and improved GVL especially beneficial in high-risk disease.
在过去的二十年中，人们将脐带血移植与部分 HLA 匹配的成人供者祖细胞相结合。在欧洲和美国，成人供者移植物经过 CD34 选择，可提供早期造血，但持久的植入来自脐带血移植物。中性粒细胞恢复迅速，急性和慢性移植物抗宿主病的发生率较低。最近的中国研究将脐带血移植物与 T 细胞充足的半相合移植物相结合。半相合移植物通常占据优势，很少检测到 UCB 嵌合体。与半相合移植或 CBU 移植相比，比较研究表明复发率显著降低，结局改善，尤其是在晚期白血病患者中。最近的一项前瞻性随机研究证实了这一点。半相合-脐带血减轻了 UCB 移植的植入延迟。UCB 移植物的独特生物学特性导致 GVHD 发生率低，GVL 效果好，尤其对高危疾病有益。
