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Lu W, Jin X, Lyu H, Bai X, Zhu H, Li X, Xiao X, Meng J, Yuan T, Li Q, Mu J, Lyu C, Jiang Y, Wei Y, Xiong X, Zhang M, Zhao M. A Prospective Trial Comparing Haploidentical Donor Transplantation With Cord Blood Versus HLA-Matched Sibling Donor Transplantation for Hematologic Malignancy Patients. Cell Transplant 2022; 31:9636897221076050. [PMID: 35168385 PMCID: PMC8855410 DOI: 10.1177/09636897221076050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Although haploidentical donor (HID) hematopoietic stem cell transplantation
(HSCT) has achieved similar survival to HLA-identical sibling donor (ISD)
transplantation, the delayed hematopoietic engraftment as well as higher
incidence of graft-versus-host-disease (GVHD), results in prolonged
hospitalization, higher costs, and increased morbidity. In this study, a
prospective, non-randomized clinical study was designed to evaluate the outcomes
of patients who underwent HID HSCT supported by cord blood or ISD HSCT. Between
May 2017 and November 2020, 113 patients were enrolled to undergo HID HSCT
supported by cord blood (n=88) or ISD HSCT (n=25). The cumulative incidence of
neutrophil and platelet engraftment at 30days was comparable in these two
groups. Importantly, there was no significant difference in the cumulative
incidence of grade II-IV aGVHD at 100days (20.5% [95% confidence interval [CI]:
12.2%–28.8%] versus 12.0% [95% CI: 0.2%–23.8%], P = 0.32) and
cGVHD at 1 year (19.5% [95% CI: 11.2%–27.8%] versus 16.6% [[95% CI: 1.3%–31.9%]
P = 0.70) between the two groups. Among the HID and ISD
groups, the 2-year disease free survival was 76.8 and 80.0% (P
= 0.83), the 2-year overall survival was 82.4 and 88.0% (P =
0.66), the 2-year GVHD-free, relapse-free survival was 68.9 and 75.3%
(P = 0.62), respectively. Our results indicate that HID
transplantation supported by cord blood may offer a good alternative to ISD HSCT
for patients with hematopoietic malignancies.
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Affiliation(s)
- Wenyi Lu
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Xin Jin
- School of Medicine, Nankai University, Tianjin, PR China
| | - Hairong Lyu
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Xue Bai
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Haibo Zhu
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Xin Li
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Xia Xiao
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Juanxia Meng
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Ting Yuan
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Qing Li
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Juan Mu
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Cuicui Lyu
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Yili Jiang
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
| | - Yunxiong Wei
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China
| | - Xia Xiong
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China
| | - Meng Zhang
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China
| | - Mingfeng Zhao
- Department of Hematology, Tianjin First Central Hospital, Tianjin, PR China.,Nankai University Affiliated First Central Hospital, Tianjin, PR China
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