Comparison of Unrelated Cord Blood Transplantation and HLA-Matched Sibling Hematopoietic Stem Cell Transplantation for Patients with Chronic Myeloid Leukemia in Advanced Stage
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- 作者：Changcheng Zheng ; Baolin Tang ; Wen Yao ; Juan Tong ; Xiaoyu Zhu ; Kaidi Song ; Liangquan Geng ; Huilan Liu ; Zimin Sun
- 关键词：Chronic myeloid leukemia ; Advanced phase ; Cord blood transplantation
- 刊名：Biology of Blood and Marrow Transplantation
- 出版年：December, 2013
- 年：2013
- 卷：19
- 期：12
- 页码：1708-1712
- 全文大小：369 K
文摘
This is the first report to present a clinical comparison of unrelated cord blood transplantation (CBT) and HLA-matched sibling allogeneic hematopoietic stem cell transplantation for patients with chronic myeloid leukemia (CML) in advanced stage (accelerated phase or blast crisis). A total of 32 consecutive patients with advanced CML received unrelated CBT (n聽=聽16) or HLA-matched sibling allogeneic peripheral blood stem cell or bone marrow transplantation (allo-PBSCT/BMT) (n聽=聽16) between 2002 and 2011. The median day to neutrophil engraftment and the median day to platelet engraftment were longer in the unrelated CBT group. The cumulative incidence of grades 1 to 2 acute graft-versus-host disease (aGVHD), grades 3 to 4 aGVHD, and chronic graft-versus-host disease did not differ significantly between the 2 cohorts. The cumulative incidence of transplantation-related mortality (TRM) at day聽+180 was higher in CBT group (37.5% versus 12.5%, P聽=聽.013). The risk of relapse was lower in CBT patients compared with that of allo-PBSCT/BMT patients (14.2% versus 42.7%, P聽=聽.03). The long-term survival in CBT group patients was slightly better than that of allo-PBSCT/BMT group, although the difference did not reach statistical significance: the 5-year overall survival for CBT patients and allo-PBSCT/BMT patients was 62.5% and 48.6%, respectively (P聽= .10), whereas the 5-year leukemia-free-survival rate was 50% and 40.5%, respectively (P聽= .12). Our comparisons suggest that patients with advanced CML receiving unrelated CBT had a lower relapse rate, a slightly better long-term survival, but a higher early TRM than those receiving HLA-matched related allo-PBSCT/BMT.