Comparison of clinical outcomes between unrelated single umbilical cord blood and"ex-vivo"T-cell depleted haploidentical transplantation in children with hematological malignancies  

作　　者：Carmen Gomez-Santos Marta Gonzalez-Vicent Blanca Molina Natalia Deltoro Blanca Herrero Julia Ruiz Antonio Perez-Martinez Miguel A Diaz 

机构地区：[1]Department of Pediatrics,Hematopoietic Stem Cell Transplantation Unit,Hospital Infantil Universitario"Nino Jesus",Menedez Pelayo 65,28009 Madrid,Spain [2]Hospital Infantil Universitario"La Pa"Madrid,Madrid,Spain

出　　处：《World Journal of Pediatrics》2021年第6期609-618,共10页世界儿科杂志（英文版）

摘　　要：Background Over the last two decades,umbilical cord blood(UCB)and haploidentical transplantation(HaploHSCT)have emerged as alternative sources of hematopoietic stem cell for allogeneic transplantation.There are few retrospective studies and no prospective studies comparing both types of alternative transplantation in pediatric patients.Results We analyzed the data of 134 children with hematological malignancies who received a hematopoietic stem cell transplantation from a single umbilical cord blood(UCB)(n=42)or an"tex-vivo"T-cell depleted transplant from a haploi-dentical-related donor(HaploHSCT)(n=92)between 1996 and 2014.Hematological recovery was faster after HaploHSCT than the UCB transplant group(median times to neutrophil and platelet recovery:13 vs.16 days,10 vs.57 days,respectively)(P<0.001).The HaploHSCT group had a significantly early immune reconstitution based on NK and CD8+T cells compared with the UCB group.However,after the first year post-transplantation.HaploHSCT had a lower number of CD4+ T and B lymphocytes compared with the UCB transplant recipients.The cumulative incidence of TRM was 29±8%in the HaploHSCT group versus 40±5%in the UCB group.Relapse incidence was 21±7%in the HaploHSCT group and 19±8%in the UCB group.Probability of DFS was 58±8%in the HaploHSCT group versus 40±9%in the UCB group(P=0.051).Conclusions TCD haploidentical transplant is associated with advantages in terms of engraftment and early immune reconstitution kinetics.TCD haploidentical transplant was associated with lower incidence of infectious and non-infectious complications,especially in the early phases of the transplant compared with UCB transplant recipients.However,there are no advantages in transplant outcomes compared with UCB transplant.

关 键 词：CHILDREN Cord blood transplant Hematologic malignancies Immune reconstitution TCD haploidentical transplant 

分 类 号：R733[医药卫生—肿瘤]