The clinical study of chronic graft-versus-host disease followinghaploidentical transplantation combined infusion with a third party cord blood
10.3760/cma.j.issn.0254-1785.2020.02.011.1
- VernacularTitle:联合第三方脐血输注的单倍体HSCT后慢性移植物抗宿主病的临床分析
- Author:
Tao TAO
1
;
Shengli XUE
;
Feng CHEN
;
Yang XU
;
Xiao MA
;
Aining SUN
;
Depei WU
Author Information
1. 苏州市第五人民医院呼吸科 215006
- Keywords:
Hematopoietic stem cell transplantation;
Chronic graft-versus-host disease;
National Institutes of Health criteria.
- From:
Chinese Journal of Organ Transplantation
2020;41(2):107-112
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence, risk factors and survival of cGVHD patients in combination of a haploidentical donor supported with an unrelated umbilical cord blood for hematopoietic stem cells transplantation (haplo-cord-HSCT).Methods:300 hematological malignancies individuals who received dual transplantation were enrolled in the study between January 2012 and July 2016 at the department of Hematology in the First Affiliated Hospital of Soochow University. The clinical diagnosis and scoring the severity of cGVHD syndromes according the National Institutes of Health (NIH) consensus conference in the 2014 update. Cox proportional hazards regression was used to identify risk factors associated with transplant outcomes.Results:During follow-up with a median time of 26.4 months (range 0.2-61.8) post transplantation, the 1-year, 3-year and 5-year cumulative incidence of cGVHD was 26.3 % (95 % confidence interval [CI], 23.5 %~29.1 %), 30.3 % (95 % CI, 27.3 %~33.3 % ) and 32.2 % (95 % CI, 28.7 %~35.7 %). For all 73 patients with cGVHD, first-line or second-line treatment were given. During the follow-up period, 53 patients survived, and 20 patients died. In multivariate analysis, the cGVHD overall survival (GOS) were associated with thrombocytopenia(<100×109/L)(HR=0.103, 95 % CI 3 %-36.1 %, P<0.001). Conclusions:Our data suggest that, the 5-year cumulative incidence of cGVHD was 32.2 % after haplo-cord-HSCT with hematological malignancies. Thrombocytopenia (<100×109/L)was independent risk factors for GOS.
