T-cell-replete haploidentical HSCT with low-dose anti-T-lymphocyte globulin compared with matched sibling HSCT and unrelated HSCT
T-cell-replete haploidentical HSCT with low-dose anti-T-lymphocyte globulin compared with matched sibling HSCT and unrelated HSCT
复制标题
使用低剂量抗 T 淋巴细胞球蛋白的充满 T 细胞的半相合 HSCT 与匹配的同胞 HSCT 和无关 HSCT 的比较
DOI：
10.1182/blood-2014-04-571570
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发表时间：
2014-10-23
期刊：
影响因子：
20.3
通讯作者：
Huang, He
中科院分区：
文献类型：
--
作者：
Luo, Yi;Xiao, Haowen;Huang, He
我们开发了一种使用低剂量抗T淋巴细胞球蛋白的T细胞充满的单倍体相合造血干细胞移植（HSCT）方法，并前瞻性地比较了在我们中心使用匹配的同胞供体（MSD），无关供体（URD）和单倍体相合的相关供体（HRD）进行的所有同期T细胞充满的HSCT的结局。2008年至2013年，90例患者接受了MSD-HSCT，116例接受了URD-HSCT，99例接受了HRD-HSCT。HRD与2 ~ 4级（42.4%）、严重急性移植物抗宿主病（17.2%）和非复发死亡率（30.5%）的发生率较高，与MSD（分别为15.6%、5.6%和4.7%; P <0.05）相比，但与URD相似，甚至与10/10 HLA完全匹配的URD相似。对于高危患者，HRD-HSCT的移植物抗白血病效应上级，HRD-HSCT的5年复发率为15.4%，URD-HSCT为28.2%（P = .07），MSD-HSCT为49.9%（P = .002）。此外，接受3种类型供体移植的患者的5年无病生存率无显著差异，MSD、URD和HRD移植分别为63.6%、58.4%和58.3%（P = 0.574）。我们的数据表明，HSCT后，适当匹配的URD和HRD与低剂量抗T淋巴细胞球蛋白的结局是相似的，HRD改善了高危白血病患者的结局。本试验在www.chictr.org（中国临床试验注册中心）注册为#ChiCTR-OCH-12002490。
We developed an approach of T-cell-replete haploidentical hematopoietic stem cell transplantation (HSCT) with low-dose anti-T-lymphocyte globulin and prospectively compared outcomes of all contemporaneous T-cell-replete HSCT performed at our center using matched sibling donors (MSDs), unrelated donors (URDs), and haploidentical related donors (HRDs). From 2008 to 2013, 90 patients underwent MSD-HSCT, 116 underwent URD-HSCT, and 99 underwent HRD-HSCT. HRDs were associated with higher incidences of grades 2 to 4 (42.4%) and severe acute graft-versus-host disease (17.2%) and nonrelapse mortality (30.5%), compared with MSDs (15.6%, 5.6%, and 4.7%, respectively; P < .05), but were similar to URDs, even fully 10/10 HLA-matched URDs. For high-risk patients, a superior graft-versus-leukemia effect was observed in HRD-HSCT, with 5-year relapse rates of 15.4% in HRD-HSCT, 28.2% in URD-HSCT (P = .07), and 49.9% in MSD-HSCT (P = .002). Furthermore, 5-year disease-free survival rates were not significantly different for patients undergoing transplantation using 3 types of donors, with 63.6%, 58.4%, and 58.3% for MSD, URD, and HRD transplantation, respectively (P = .574). Our data indicate that outcomes after HSCT from suitably matched URDs and HRDs with low-dose anti-T-lymphocyte globulin are similar and that HRD improves outcomes of patients with high-risk leukemia. This trial was registered at www.chictr.org (Chinese Clinical Trial Registry) as #ChiCTR-OCH-12002490.