Comparison of Donor Sources in Hematopoietic Stem Cell Transplantation for Childhood Acute Leukemia: A Nationwide Retrospective Study.

Comparison of Donor Sources in Hematopoietic Stem Cell Transplantation for Childhood Acute Leukemia: A Nationwide Retrospective Study.
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儿童急性白血病造血干细胞移植供体来源的比较：全国回顾性研究。

DOI：
10.1016/j.bbmt.2016.09.020
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发表时间：
2016
期刊：
Biol Blood Marrow Transplant.
影响因子：
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通讯作者：
Donor/Source Working Group of Japan Society of Hematopoietic Cell Transplantat
Donor/Source Working Group of Japan Society of Hematopoietic Cell Transplantat
中科院分区：
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文献类型：
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作者：
Sakaguchi H;Watanabe N;Matsumoto K;Yabe H;Kato S;Ogawa A;Inagaki J;Goto H;Koh K;Yoshida N;Kato K;Cho Y;Kosaka Y;Takahashi Y;Inoue M;Kato K;Atsuta Y;Miyamura K;Donor/Source Working Group of Japan Society of Hematopoietic Cell Transplantat

文献摘要

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异基因造血干细胞移植(allo-HSCT)仍然是儿童高危急性白血病的最佳治疗选择。然而，对于没有完全相同的兄弟姐妹的儿童来说，哪种捐赠者来源是最好的仍然不清楚。为了评价供者来源对儿童急性白血病异基因造血干细胞移植的临床影响，我们利用日本造血细胞移植学会的登记资料，分析了2005年至2012年在第一或第二次完全缓解期间接受清髓方案的577例儿童异基因造血干细胞移植的资料，并比较了7/8至8/8 = 等位基因相合无关骨髓移植(UR-BMT，n HLA218)和4/6至6/6 HLA等位基因相合无关骨髓移植(UR-CBT，n = 200)的结果。N = 159)。幸存者的中位随访期为40.0个月。ID-BMT、UR-BMT和UR-CBT的3年总生存率和无白血病生存率分别为74.8%和69.0%、75.0%和69.6%、71.8%和63.8%。多变量分析表明，3组的OS和LFS具有可比性，尽管在儿童高危急性白血病的清髓环境中，UR-CBT具有更高的无复发死亡风险(风险比，2.20；P= .03)。
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the best therapeutic option for childhood high-risk acute leukemia. However, which donor source is optimal for children lacking an identical sibling remains unclear. To evaluate the clinical impact of donor source on allo-HSCT in childhood acute leukemia, we analyzed data from 577 children who underwent allo-HSCT after a myeloablative regimen during first or second complete remission from 2005 to 2012, using registry data of the Japan Society for Hematopoietic Cell Transplantation, and we compared outcomes of 7/8 to 8/8 HLA allelic–matched unrelated bone marrow transplantation (UR-BMT, n = 218) and 4/6 to 6/6 HLA allelic–matched unrelated cord blood transplantation (UR-CBT, n = 200) to those of HLA-identical related bone marrow transplantation (ID-BMT, n = 159). The median follow-up of survivors was 40.0 months. Three-year overall survival (OS) and leukemia-free survival (LFS) rates for ID-BMT, UR-BMT, and UR-CBT were 74.8% and 69.0%, 75.0% and 69.6%, and 71.8% and 63.8%, respectively. The multivariate analysis demonstrated that OS and LFS for the 3 groups are comparable, although UR-CBT carries a greater risk of nonrelapse mortality (hazard ratio, 2.20;P= .03, compared to ID-BMT) in the myeloablative setting for childhood high-risk acute leukemia.