A comparative study of unrelatedversus matched-sibling donor allogeneic hematopoietic stem cell transplantation for leukemic children

Binglei Zhang, Jian Zhou, Yanli Zhang, R. Gui, Yuewen Fu, Y. Zu, F. Yu, Hui-fang Zhao, Zhen Li, B. Fang, Xudong Wei
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Abstract

Objective To evaluate the efficacy of unrelated donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for leukemic children. Methods Clinical data of 54 leukemic children undergoing allo-HSCT were retrospectively analyzed from May 2006 to March 2018. According to the source of donor, they were divided into matched sibling donor allo-HSCT group (MSD, n=27) and unrelated donor group (URD, n=27). The clinical outcomes of leukemic children receiving URD allo-HSCT were assessed and those in MSD allo-HSCT group were enrolled as control. Results One patient with refractory AML was not implanted in URD group and the remaining 53 cases were successful in hematopoietic reconstitution. The time of neutrophil and platelet, the incidence of acute graft-versus-host disease (aGVHD), chronic GVHD (cGVHD), generalized cGVHD and their transplant-related complications including pulmonary complications, hemorrhagic cystitis between two groups were not statistically different (P>0.05). The incidence of serious aGVHD, cytomegalovirus (CMV) and EB virus (EBV) infection was significantly higher in URD group than that in MSD group (P 0.05). Conclusions In leukemic children, although the incidence of complications post URD allo-HSCT is significantly increased, the prognosis is comparable to MSD allo-HSCT. It is a good choice when there is no suitable sibling donor. Key words: Allogeneic hematopoietic stem cell transplantation; Children; Leukemia; Unrelated donor; Matched sibling donor
非亲缘与配对兄弟姐妹供体异基因造血干细胞移植治疗白血病儿童的比较研究
目的探讨非亲属供体异体造血干细胞移植治疗儿童白血病的疗效。方法回顾性分析2006年5月至2018年3月54例接受同种异体造血干细胞移植的白血病患儿的临床资料。根据供体来源将其分为匹配的兄弟姐妹供体同种异体造血干细胞组(MSD, n=27)和无血缘关系供体组(URD, n=27)。评估接受URD同种异体造血干细胞移植的白血病儿童的临床结果,并将MSD同种异体造血干细胞移植组的儿童作为对照。结果1例难治性急性髓系白血病患者未植入URD,其余53例患者造血重建成功。两组患者的中性粒细胞和血小板时间、急性移植物抗宿主病(aGVHD)、慢性移植物抗宿主病(cGVHD)、全身性移植物抗宿主病(cGVHD)发生率及肺并发症、出血性膀胱炎等移植物相关并发症发生率比较,差异均无统计学意义(P < 0.05)。URD组严重aGVHD、巨细胞病毒(CMV)、EB病毒(EBV)感染发生率显著高于MSD组(P < 0.05)。结论在白血病儿童中,虽然URD异体造血干细胞移植后并发症的发生率明显增加,但预后与MSD异体造血干细胞移植相当。当没有合适的兄弟姐妹供体时,这是一个很好的选择。关键词:异基因造血干细胞移植;孩子;白血病;无关的捐赠;匹配的兄弟姐妹供体
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