Comparable Outcomes after Hematopoietic Stem Cell Transplantation from Mother Donors and Matched Unrelated Donors in Patients with Hematopoietic Malignancies
Comparable Outcomes after Hematopoietic Stem Cell Transplantation from Mother Donors and Matched Unrelated Donors in Patients with Hematopoietic Malignancies
复制标题
造血系统恶性肿瘤患者的母亲捐献者和匹配的非亲属捐献者的造血干细胞移植后的可比较结果
DOI：
10.1016/j.bbmt.2019.01.030
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发表时间：
2019
影响因子：
4.3
通讯作者：
Wang Yu
中科院分区：
文献类型：
--
作者：
Ma Rui;Huang Xiao-Jun;Xu Lan-Ping;Liu Kai-Yan;Zhang Xiao-Hui;Yan Chen-Hua;Han Wei;Wang Feng-Rong;Chen Yu-Hong;Chen Huan;Chen Yao;Wang Jing-Zhi;Wang Yu
单倍体相合移植的存活率与 HLA 完全匹配的无关供体 (URD) 相当。在选择 HLA 单倍体移植的最佳供体时，大多数机构优先使用年轻男性供体而不是母亲供体。在一项回顾性研究中，我们比较了母亲供体移植和 URD 移植的结果。我们发现，母亲供体组和 URD 组的 2 年总生存率和 2 年无白血病生存率相当（分别为 74.8% 与 72.9%，P=.937，以及 71.7% 与 67.0%，P=.580）。在母亲供体组中观察到 II 级至 IV 级急性移植物抗宿主病 (GVHD) 和慢性 GVHD 的发生率高于 URD 组（分别为 43.5% 与 14.0%，P=.001，以及 62.2% 与 38.7%，P=.007）。母亲供体组的 2 年累积复发率显着降低（7.6% 对比 20.9%，P=0.036）。这些发现表明，母亲供体移植可以实现与 URD 移植相当的生存率，并且复发率降低，但 GVHD 发生率增加，这表明母亲供体移植将是没有相同兄弟姐妹供体的患者的合适选择。
Haploidentical transplantations have achieved comparable survival as HLA fully matched unrelated donors (URDs). When choosing the best donor for HLA haploidentical transplantations, most institutions prioritize using young male donors over mother donors. In a retrospective study we compared outcomes in mother donor and URD transplantations. We found that both 2-year overall survival and 2-year leukemia-free survival were comparable between the mother donor group and URD group (74.8% versus 72.9%,P= .937, and 71.7% versus 67.0%,P= .580, respectively). Higher incidences of grades II to IV acute graft-versus-host disease (GVHD) and chronic GVHD were observed in the mother donor group than in the URD group (43.5% versus 14.0%,P= .001, and 62.2% versus 38.7%,P= .007, respectively). The 2-year cumulative incidences of relapse were significantly decreased in the mother donor group (7.6% versus 20.9%,P= .036). These findings suggest mother donor transplantations could achieve comparable survival with URD transplantations and exhibited decreased rates of relapse but increased rates of GVHD, indicating that mother donors would be a suitable choice for patients without an identical sibling donor.