HLA-haploidentical blood and bone marrow transplantation with anti-thymocyte globulin: Long-term comparison with HLA-identical sibling transplantation
HLA-haploidentical blood and bone marrow transplantation with anti-thymocyte globulin: Long-term comparison with HLA-identical sibling transplantation
复制标题
DOI：
10.1016/j.bcmd.2009.02.005
复制
发表时间：
2009-07-01
影响因子：
2.3
通讯作者：
Wang, Qing-Yu
中科院分区：
文献类型：
--
作者：
Chen, Xing-Hua;Gao, Lei;Wang, Qing-Yu
我们介绍了我们在白血病患者中进行相关的人类白细胞抗原单倍体相合和相合同胞造血干细胞移植的最新结果。我们比较了107例白血病患者在同一时期接受了人类白细胞抗原相合的同胞(n=51)或相关的人类白细胞抗原半相合的(n=56)异基因造血干细胞移植的结果。采用BU-CY/CY-TBI或半相合HSCT中的TBI+Ara-C+CY+ATG/CCNU+Ara-C+Bu+CY+ATG作为预适应方案，然后进行未经处理的骨髓和/或外周血(PB)移植。所有患者均达到完全植骨。配对和半相合队列中II~IV级急性移植物抗宿主病(AGvHD)的累积发生率分别为13.7%和26.8%(P<0.05)。配对和单倍体相合患者的两年治疗相关死亡率分别为7.8%和12.5%，P>；0.05，复发率分别为17%和22%，P>；0.05。配对和半相合患者的两年调整后无白血病存活率分别为76%和68%，P>；0.05，匹配和半相合患者的总体存活率分别为80%和70%，P>；0.05。多变量分析显示，只有疾病晚期和诊断为急性白血病与复发、治疗失败和总死亡率的增加有关。综上所述，对相关的人类白细胞抗原半相合供者进行HSCT是一种可行的方法，结果可以接受。(C)2009 Elsevier Inc.保留所有权利。
We present an update of our results regarding related HLA-haploidentical and HLA-identical sibling hematopoietic stem cell transplantation (HSCT) in patients with leukemia. We compared the outcomes of 107 patients with leukemia undergoing HLA-identical sibling (n = 51) or related HLA-haploidentical (n = 56) HSCT performed during the same time period. Patients received BU-CY/CY-TBI in HLA-identical sibling HSCT or TBI + Ara-C + CY + ATG/CCNU + Ara-C + Bu + CY + ATG in haploidentical HSCT as conditioning regimens, followed by unmanipulated marrow and/or peripheral blood (PB) transplantation. All patients achieved full engraftment. The cumulative incidence of grades II through IV acute graft-versus-host disease (aGvHD) in the matched and haploidentical cohorts was 13.7% and 26.8% (P0.05). The two-year incidence of treatment-related mortality for matched and haploidentical patients was 7.8% and 12.5%, respectively, with P>0.05, and the incidence of relapse was 17% and 22%, respectively, with P>0.05. The two-year adjusted leukemia-free survival for matched versus haploidentical patients was 76% and 68%, respectively, with P>0.05, and the overall survival for matched versus haploidentical patients was 80% and 70%, respectively, with P>0.05. Multivariate analyses showed that only advanced disease stage and a diagnosis of acute leukemia were related to increased risk of relapse, treatment failure, and overall mortality. In summary, HSCT performed with related HLA-haploidentical donors is a feasible approach with acceptable outcomes. (C) 2009 Elsevier Inc. All rights reserved.