文章：

无关脐带血移植后的移植物抗骨髓增生异常综合征效应：日本造血干细胞移植数据中心752例患者回顾性分析

Graft-versus-MDS effect after unrelated cord blood transplantation: a retrospective analysis of 752 patients registered at the Japanese Data Center for Hematopoietic Cell Transplantation

原文发布日期：2019-03-06

DOI: 10.1038/s41408-019-0192-x

类型: Article

开放获取: 是

英文摘要：

Allogeneic hematopoietic stem cell transplantation is the sole curative therapy for myelodysplastic syndrome (MDS). However, there is concern regarding graft failure and relapse in patients who undergo cord blood transplantation (CBT). We conducted a retrospective study of the CBT outcomes in MDS patients using the Japanese Data Center for Hematopoietic Cell Transplantation database. Seven hundred fifty-two de novo MDS patients of ≥18 years of age (median, 58 years) undergoing their first CBT between 2001 and 2015 were examined. Two-thirds of the patients were male, and were RAEB. The cumulative incidences of neutrophil and platelet engraftment at day 100 were 77 and 59%, respectively. The 3-year overall survival (OS) was 41% and the median survival of the patients was 1.25 years. A multivariate analysis of pre-transplant variables showed that the age, gender, cytogenetic subgroups, number of RBC transfusions, HCT-CI and year of CBT significantly influenced the outcome. The cumulative incidence of acute graft-versus-host disease (aGVHD) and chronic GVHD (cGVHD) was 32 and 21%, respectively. A survival benefit was observed in patients who developed cGVHD, but not aGVHD. Our results suggest that CBT is an acceptable alternative graft and that a graft-versus-MDS effect can be expected, especially in patients who develop cGVHD.
 

摘要翻译： 

异基因造血干细胞移植是骨髓增生异常综合征（MDS）的唯一根治性疗法。然而，脐血移植（CBT）患者存在移植失败和复发的担忧。我们利用日本造血细胞移植数据中心的资料，对接受CBT的MDS患者结局进行了回顾性研究。研究对象为2001年至2015年间首次接受CBT的752例新发MDS成年患者（中位年龄58岁），其中三分之二为男性且属于难治性贫血伴原始细胞增多型（RAEB）。中性粒细胞和血小板植入的100天累积发生率分别为77%和59%。三年总生存率（OS）为41%，患者中位生存期为1.25年。移植前变量的多因素分析显示，年龄、性别、细胞遗传学亚组、红细胞输注次数、造血细胞移植合并症指数（HCT-CI）及CBT年份均显著影响预后。急性移植物抗宿主病（aGVHD）和慢性GVHD（cGVHD）累积发生率分别为32%和21%。发生cGVHD（而非aGVHD）的患者显现出生存获益。我们的研究结果表明，脐血移植是可接受的替代移植物，且可预期产生移植物抗MDS效应，尤其在发生cGVHD的患者群体中。

原文链接：

Graft-versus-MDS effect after unrelated cord blood transplantation: a retrospective analysis of 752 patients registered at the Japanese Data Center for Hematopoietic Cell Transplantation