Comparison of the clinical outcomes of hematologic malignancies after myeloablative haploidentical transplantation with G-CSF/ATG and posttransplant cyclophosphamide:results from the Chinese Bone Marrow Transplantation Registry Group(CBMTRG)  

作　　者：Feifei Tang Yajing Xu Huiren Chen Lanping Xu Xiaohui Zhang Yu Wang Qifa Liu Depei Wu Xiaojun Huang 

机构地区：[1]Peking University People’s Hospital,Peking University Institute of Hematology,Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation,Beijing 100044,China [2]Xiangya Hospital,Central South University,Changsha 410008,China [3]PLA Army General Hospital,Beijing 100700,China [4]Nanfang Hospital,Southern Medical University,Guangzhou 510515,China [5]The First Affiliated Hospital of Soochow University,Suzhou 215006,China [6]Peking-Tsinghua Center for Life Sciences,Beijing 100871,China

出　　处：《Science China(Life Sciences)》2020年第4期571-581,共11页中国科学（生命科学英文版）

基　　金：This work was supported by the National Natural Science Foundation of China(81670167);the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(81621001);sponsored by the Fund for Fostering Young Scholars of Peking University Health Science Center(BMU2017PY010)。

摘　　要：This study compared G-CSF/ATG and PTCy in myeloablative haploidentical hematopoietic stem cell transplantation(haploHSCT)for hematologic malignancies between January 2013 and March 2018 reporting to the Chinese Bone Marrow Transplantation Registry Group(CBMTRG).For each PTCy,G-CSF/ATG subjects(1:4)were selected using the nested case-pair method.In total,220 patients including 176 in G-CSF/ATG group and 44 in PTCy group were analyzed.The incidences of 30-day neutrophil engraftment(88.6%vs.96.6%,P=0.001),90-day platelet engraftment(84.1%vs.94.2%,P=0.04),the median time to neutrophil engraftment(17 days vs.12 days,P=0.000)and platelet engraftment(22 days vs.17 days,P=0.001)were significantly inferior in PTCy group.The incidences of grades 2–4 and 3–4 acute graft-versus-host disease(GVHD),chronic GVHD and severe chronic GVHD were comparable.Among G-CSF/ATG and PTCy groups,the 3-year progression-free survival,overall survival,cumulative incidences of nonrelapse mortality and relapse was 74.3%vs.61%(P=0.045),78.3%vs.65.2%(P=0.039),12%vs.27.3%(P=0.008),and 14.9%vs.11.7%(P=0.61),respectively.G-CSF/ATG can achieve better engraftment,PFS and OS,and lower incidence of NRM compared to PTCy in myeloablative haplo-HSCT for hematologic malignancies.This study compared G-CSF/ATG and PTCy in myeloablative haploidentical hematopoietic stem cell transplantation(haploHSCT) for hematologic malignancies between January 2013 and March 2018 reporting to the Chinese Bone Marrow Transplantation Registry Group(CBMTRG). For each PTCy, G-CSF/ATG subjects(1:4) were selected using the nested case-pair method. In total, 220 patients including 176 in G-CSF/ATG group and 44 in PTCy group were analyzed. The incidences of 30-day neutrophil engraftment(88.6% vs. 96.6%, P=0.001), 90-day platelet engraftment(84.1% vs. 94.2%, P=0.04), the median time to neutrophil engraftment(17 days vs. 12 days, P=0.000) and platelet engraftment(22 days vs. 17 days, P=0.001) were significantly inferior in PTCy group. The incidences of grades 2–4 and 3–4 acute graft-versus-host disease(GVHD), chronic GVHD and severe chronic GVHD were comparable. Among G-CSF/ATG and PTCy groups, the 3-year progression-free survival, overall survival, cumulative incidences of nonrelapse mortality and relapse was 74.3% vs. 61%(P=0.045), 78.3% vs.65.2%(P=0.039), 12% vs. 27.3%(P=0.008), and 14.9% vs. 11.7%(P=0.61), respectively. G-CSF/ATG can achieve better engraftment, PFS and OS, and lower incidence of NRM compared to PTCy in myeloablative haplo-HSCT for hematologic malignancies.

关 键 词：MYELOABLATIVE HAPLOIDENTICAL transplantation GRANULOCYTE colony-stimulating factor antithymocyte GLOBULIN posttransplantation CYCLOPHOSPHAMIDE 

分 类 号：R733[医药卫生—肿瘤]