Comparison of clinical outcomes between peripheral blood stem cells and peripheral blood stem cells plus bone marrow in myelodysplastic syndrome patients with haploidentical transplantation
Comparison of clinical outcomes between peripheral blood stem cells and peripheral blood stem cells plus bone marrow in myelodysplastic syndrome patients with haploidentical transplantation
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DOI：
10.1038/s41409-022-01862-9
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发表时间：
2022-11
影响因子：
4.8
通讯作者：
Mengqian Chu;Shu-Lin Hu;Yifan Shen;Danya Shen;Yuchen Zhan;Yi Fan;Jia Chen;Xiaowen Tang;
中科院分区：
文献类型：
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作者：
Mengqian Chu;Shu-Lin Hu;Yifan Shen;Danya Shen;Yuchen Zhan;Yi Fan;Jia Chen;Xiaowen Tang;
对于骨髓增生异常综合征（MDS）患者，半相合G-CSF动员的外周血和骨髓移植（HBMT）与半相合G-CSF致敏的外周血干细胞移植（HPBSCT）的比较尚不清楚。我们使用倾向评分法对2016年6月至2021年6月期间在我们中心接受HPBSCT（n= 46）或HBMT（n= 94）的140例MDS患者进行了回顾性分析，这些患者在移植前接受BU/CY作为预处理方案。HBMT接受者与III-IV级急性GVHD的发生率降低相关（17. 22% vs. 30.57%，p = 0.019）在100天内，降低了2年移植相关死亡率（TRM）（14.29% vs. 28.94%，p = 0.045）和上级2年总生存率（OS）（81.6% vs. 66.0%，p = 0.027），无进展生存期（PFS）与HPBSCT相比，GVHD患者的无复发生存率（GRFS）（64.6%vs.53.3%，p = 0.062）和2年复发率（RI）（5.96%vs.9.39%，p = 0.445）没有受到影响。多变量分析显示，GPB/GBM混合物是III-IV级急性GVHD（p= 0.018）和TRM（p= 0.048）发生率降低、OS（p= 0.029）、PFS（p= 0.019）和GRFS（p= 0.072）改善的独立因素。总的来说，使用GPB/GBM混合物作为MDS患者单倍HSCT的干细胞移植物似乎是最佳选择。
The comparison of haploidentical G-CSF-mobilized peripheral blood and bone marrow transplantation (HBMT) for patients with myelodysplastic syndrome (MDS) and haploidentical G-CSF-primed peripheral blood stem cell transplantation (HPBSCT) remains unclear. We performed a retrospective analysis using a propensity score method on 140 MDS patients who received HPBSCT (n= 46) or HBMT (n= 94) with BU/CY as a conditioning regimen prior to transplantation at our center between June 2016 and June 2021. HBMT recipients were associated with a reduced incidence of grade III-IV acute GVHD (17.22% vs. 30.57%,p= 0.019) within 100 days, reduced 2-year transplant-related mortality (TRM) (14.29% vs. 28.94%,p= 0.045) and superior 2-year overall survival (OS) (81.6% vs. 66.0%,p= 0.027), progression-free survival (PFS) (80.9% vs. 61.2%,p= 0.015), and GVHD relapse-free survival (GRFS) (64.6% vs. 53.3%,p= 0.062) compared with HPBSCT, but 2-year relapse incidence (RI) (5.96% vs. 9.39%,p= 0.445) was not affected. Multivariate analysis revealed that a GPB/GBM mixture was the independent factor for a reduced incidence of grade III-IV acute GVHD (p= 0.018) and TRM (p= 0.048), improved OS (p= 0.029), PFS (p= 0.019) and GRFS (p= 0.072). Collectively, the use of a GPB/GBM mixture as stem cell grafts for haplo-HSCT in patients with MDS appears to be an optimal choice.