Prognostic factors for adult single cord blood transplantation among European and Japanese populations: the Eurocord/ALWP-EBMT and JSHCT/JDCHCT collaborative study
Prognostic factors for adult single cord blood transplantation among European and Japanese populations: the Eurocord/ALWP-EBMT and JSHCT/JDCHCT collaborative study
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DOI：
10.1038/s41375-019-0534-5
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发表时间：
2020-01-01
期刊：
影响因子：
11.4
通讯作者：
Gluckman, Eliane
中科院分区：
文献类型：
--
作者：
Kanda, Junya;Hayashi, Hiromi;Gluckman, Eliane
患者和移植背景的巨大差异使得很难在不同人群中确定无关脐带血移植（UCBT）的一致预后因素。因此，我们在Eurocord/ALWP-EBMT和JSHCT/JDCHCT之间进行了一项合作研究。接受过单次UCBT的急性白血病成人患者符合条件。JSHCT/JDCHCT和Eurocord/ALWP-EBMT登记研究分别共纳入3764例和1027例患者。日本和欧洲队列的中位年龄分别为51岁和38岁。在日本队列中更频繁地观察到三个或更多个HLA错配。日本和欧洲队列的中位总有核细胞（TNC）计数分别为2.58和3.51 x 107/kg。抗胸腺细胞球蛋白仅在2%的日本队列中使用，而在欧洲队列中为65%。JSHCT/JDCHCT的3年总生存率（OS）为41%，Eurocord/ALWP-EBMT为33%。在多变量分析中，TNC剂量和HLA配型对两个队列的OS均无显著影响，而移植年份、年龄和精确的疾病风险指数影响两个队列的OS。尽管日本和欧洲队列的特征存在相当大的差异，但我们在两个登记研究中观察到影响成人急性白血病患者UCBT结局的相似预后因素。
Large differences in patient and transplant backgrounds make it difficult to identify consistent prognostic factors of unrelated cord blood transplantation (UCBT) among different populations. Thus, we performed a collaborative study between Eurocord/ALWP-EBMT and JSHCT/JDCHCT. Adults with acute leukaemia who underwent a single UCBT were eligible. In total, 3764 and 1027 patients of the JSHCT/JDCHCT and Eurocord/ALWP-EBMT registries, respectively, were included. The median ages of the Japanese and European cohorts were 51 and 38 years, respectively. Three or more HLA mismatches were more frequently observed in the Japanese cohort. The median total nucleated cell (TNC) counts were 2.58 and 3.51 x 107/kg in the Japanese and European cohorts, respectively. Anti-thymocyte globulin was used in only 2% of the Japanese cohort compared with 65% of the European cohort. The 3-year overall survival (OS) was 41% in JSHCT/JDCHCT and 33% in Eurocord/ALWP-EBMT. In the multivariate analysis, TNC dose and HLA matching had no significant effect on OS in either cohort, whereas year of transplantation, age, and refined disease risk index affected OS in both cohorts. Despite considerable differences in characteristics between the Japanese and European cohorts, we observed similar prognostic factors affecting UCBT outcomes in adult patients with acute leukaemia in both registries.