Retrospective cohort study comparing the outcomes of intravenous busulfan vs. total-body irradiation after single cord blood transplantation
Retrospective cohort study comparing the outcomes of intravenous busulfan vs. total-body irradiation after single cord blood transplantation
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DOI：
10.1038/s41409-019-0441-4
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发表时间：
2019-10-01
影响因子：
4.8
通讯作者：
Sun, Zimin
中科院分区：
文献类型：
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作者：
Tang, Baolin;Zhu, Xiaoyu;Sun, Zimin
由于干细胞剂量不足，脐带血移植（UCBT）会导致移植失败增加和造血恢复延迟。预处理方案对于植入至关重要，并且已经进行了大量试验来比较 IV Bu 和 TBI 的结果，但没有 UCBT 的比较数据。我们进行了一项回顾性多中心研究来分析 IV Bu 和 TBI 对患有血液系统恶性肿瘤的 UCBT 患者的结果。 2008年5月1日至2018年3月31日期间，共有来自中国脐带血移植公司的331名患者（IV Bu，n = 131；TBI，n = 200）接受了评估。 IV Bu/Cy 队列中中性粒细胞植入的累积发生率为 91.6%，Cy/TBI 队列中为 98.0%（P < 0.001）。中性粒细胞植入的中位时间分别为 16 天和 19 天（P < 0.001）。多变量分析显示非复发死亡率（风险比[HR]，1.11；95%置信区间[CI]，0.66至1.86；P = 0.695）、复发（HR，0.90；95% CI，0.50至1.60；P = 0.713）和总生存率（HR，0.94；95% CI， 0.61 至 1.44；P = 0.763) 两种预处理方案之间。我们的结果表明，对于接受 UCBT 治疗的血液恶性肿瘤患者来说，IV Bu 和 TBI 都是有效的清髓预处理方案。
Limited to inadequate stem-cell doses, cord blood transplantation (UCBT) is accompanied by increased graft failure and delayed haematopoietic recovery. The conditioning regimen is critically important for engraftment, and numerous trials have been undertaken comparing the outcomes of IV Bu and TBI, but there are no comparative data for UCBT. We conducted a retrospective multicentre study to analyse the outcomes of IV Bu and TBI in UCBT patients with haematologic malignancies. Between 1 May, 2008 and 31 Mar, 31 2018, a total of 331 patients from the China Umbilical Cord Blood Transplantation Corporation (IV Bu, n = 131; TBI, n = 200) were evaluated. The cumulative incidence of neutrophil engraftment was 91.6% in the IV Bu/Cy cohort and 98.0% in the Cy/TBI cohort (P < 0.001). The median times to neutrophil engraftment were 16 and 19 days (P < 0.001), respectively. Multivariate analysis showed no statistical difference for nonrelapse mortality (hazard ratio [HR], 1.11; 95% confidence interval [CI], 0.66 to 1.86; P = 0.695), relapse (HR, 0.90; 95% CI, 0.50 to 1.60; P = 0.713) and overall survival (HR, 0.94; 95% CI, 0.61 to 1.44; P = 0.763) between the two conditioning regimens. Our results show that both IV Bu and TBI are valid myeloablative conditioning regimens for haematologic malignancy patients treated with UCBT.