文章：

脐带血与非亲缘供者移植治疗原发性难治性或复发性急性髓系白血病成人患者的比较：来自欧洲骨髓移植协作组（EBMT）Eurocord、急性白血病工作组及细胞治疗与免疫生物学工作组脐带血委员会的报告

Umbilical cord blood versus unrelated donor transplantation in adults with primary refractory or relapsed acute myeloid leukemia: a report from Eurocord, the Acute Leukemia Working Party and the Cord Blood Committee of the Cellular Therapy and Immunobiology Working Party of the EBMT

原文发布日期：2019-04-12

DOI: 10.1038/s41408-019-0204-x

类型: Article

开放获取: 是

英文摘要：

The role of umbilical cord blood transplantation (CBT) in acute myeloid leukemia (AML) patients with active disease at allogeneic hematopoietic cell transplantation (allo-HCT) remains poorly investigated. In this study, we compared transplantation outcomes of 2963 patients with primary refractory or relapsed AML given CBT, 10/10 HLA-matched UD, or 9/10 HLA-matched UD allo-HCT from 2004 to 2015 at EBMT-affiliated centers. Neutrophil engraftment and complete remission rates in CBT, UD 10/10, and UD 9/10 recipients were 75 and 48%, 93 and 69%, and 93 and 70%, respectively. In multivariate Cox analyses, in comparison with CBT (n = 285), UD 10/10 recipients (n = 2001) had a lower incidence of relapse (HR = 0.7, P = 0.001), a lower incidence of non relapse mortality (HR = 0.6, P < 0.001), better GVHD-free and leukemia-free survival (GRFS, HR = 0.8, P < 0.001) and better survival (HR = 0.6, P < 0.001). Further, in comparison with CBT, 9/10 UD recipients (n = 677) also had a lower incidence of relapse (HR = 0.8, P = 0.02), a lower incidence of nonrelapse mortality (HR = 0.7, P = 0.008), better GRFS (HR = 0.8, P = 0.01) and better survival (HR = 0.7, P < 0.001). In summary, these data suggest that in AML patients with active disease at transplantation, allo-HCT with UD results in better transplantation outcomes than CBT.
 

摘要翻译： 

脐带血移植（CBT）在异基因造血细胞移植（allo-HCT）时疾病仍处于活动期的急性髓系白血病（AML）患者中的作用尚未得到充分研究。本研究比较了2004年至2015年间在EBMT附属中心接受CBT、10/10 HLA匹配的非亲缘供者（UD）或9/10 HLA匹配的非亲缘供者allo-HCT的2963例原发性难治性或复发性AML患者的移植结果。CBT组、UD 10/10组和UD 9/10组的中性粒细胞植入率和完全缓解率分别为75%和48%、93%和69%、93%和70%。在多变量Cox分析中，与CBT组（n=285）相比，UD 10/10组（n=2001）具有较低的复发率（HR=0.7，P=0.001）、较低的非复发死亡率（HR=0.6，P<0.001）、更好的无移植物抗宿主病无白血病生存率（GRFS，HR=0.8，P<0.001）和更好的总生存率（HR=0.6，P<0.001）。此外，与CBT组相比，UD 9/10组（n=677）也具有较低的复发率（HR=0.8，P=0.02）、较低的非复发死亡率（HR=0.7，P=0.008）、更好的GRFS（HR=0.8，P=0.01）和更好的总生存率（HR=0.7，P<0.001）。总之，这些数据表明，在移植时疾病仍处于活动期的AML患者中，采用非亲缘供者进行allo-HCT比CBT能带来更好的移植结果。

原文链接：

Umbilical cord blood versus unrelated donor transplantation in adults with primary refractory or relapsed acute myeloid leukemia: a report from Eurocord, the Acute Leukemia Working Party and the Cord Blood Committee of the Cellular Therapy and Immunobiology Working Party of the EBMT