Cargando…

Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies

Allogeneic haploidentical HSCT (haplo-HSCT) and unrelated umbilical cord blood transplantation(UCBT)are used in patients lacking HLA-identical sibling or unrelated donors. With myeloablative condition and GVHD prophylaxis of using low-dose ATG and post-transplantation cyclophosphamide (PTCY), we con...

Descripción completa

Detalles Bibliográficos
Autores principales: Li, Hua, Li, Xiaofan, Chen, Yiling, Li, Duihong, Chen, Xianling, Zhu, Zhijuan, Wang, Yiting, Huang, Jiafu, Chen, Ping, Chen, Yuanzhong, Li, Nainong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599442/
https://www.ncbi.nlm.nih.gov/pubmed/34804017
http://dx.doi.org/10.3389/fimmu.2021.733326
_version_ 1784600957286350848
author Li, Hua
Li, Xiaofan
Chen, Yiling
Li, Duihong
Chen, Xianling
Zhu, Zhijuan
Wang, Yiting
Huang, Jiafu
Chen, Ping
Chen, Yuanzhong
Li, Nainong
author_facet Li, Hua
Li, Xiaofan
Chen, Yiling
Li, Duihong
Chen, Xianling
Zhu, Zhijuan
Wang, Yiting
Huang, Jiafu
Chen, Ping
Chen, Yuanzhong
Li, Nainong
author_sort Li, Hua
collection PubMed
description Allogeneic haploidentical HSCT (haplo-HSCT) and unrelated umbilical cord blood transplantation(UCBT)are used in patients lacking HLA-identical sibling or unrelated donors. With myeloablative condition and GVHD prophylaxis of using low-dose ATG and post-transplantation cyclophosphamide (PTCY), we conducted a prospective clinical trial. Of eligible 122 patients from February 2015 to December 2019 in the study, 113 patients were involved. Forty-eight patients were in the group of sequential haplo-cord transplantation (haplo-cord HSCT), and 65 patients were in the group of single UCBT. The primary endpoint of 2-year disease-free survival (DFS) was no statistical difference between groups (64.1 vs. 56.5%), p>0.05. The analysis of subgroup patients with relapsed/refractory showed haplo-cord HSCT was associated with better OS (HR 0.348, 95% CI, 0.175–0.691; p=0.0025), DFS (HR 0.402, 95% CI, 0.208–0.779; p=0.0069), and GRFS (HR 0.235, 95% CI, 0.120–0.457, p<0.0001) compared to the single cord group. The 2-year’s probability in OS, DFS, and GRFS was 64.9 vs. 31.6%, 64.5 vs. 31.6%, and 60.8 vs. 15.0% in the haplo-cord group and single cord group, respectively. III-IV acute GVHD 8.3 vs. 6.2%, chronic GVHD 25.8 vs. 13.7%, and extensive chronic GVHD 5.3 vs. 1.8% were shown in corresponding group, p>0.05. The patients engrafted persistently with UCB showed better survival outcomes. Our sequential Haplo-cord HSCT with ATG/PTCY improved the survival of patients and might be an alternative transplantation approach for patients with relapsed/refractory hematologic malignancies.
format Online
Article
Text
id pubmed-8599442
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-85994422021-11-19 Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies Li, Hua Li, Xiaofan Chen, Yiling Li, Duihong Chen, Xianling Zhu, Zhijuan Wang, Yiting Huang, Jiafu Chen, Ping Chen, Yuanzhong Li, Nainong Front Immunol Immunology Allogeneic haploidentical HSCT (haplo-HSCT) and unrelated umbilical cord blood transplantation(UCBT)are used in patients lacking HLA-identical sibling or unrelated donors. With myeloablative condition and GVHD prophylaxis of using low-dose ATG and post-transplantation cyclophosphamide (PTCY), we conducted a prospective clinical trial. Of eligible 122 patients from February 2015 to December 2019 in the study, 113 patients were involved. Forty-eight patients were in the group of sequential haplo-cord transplantation (haplo-cord HSCT), and 65 patients were in the group of single UCBT. The primary endpoint of 2-year disease-free survival (DFS) was no statistical difference between groups (64.1 vs. 56.5%), p>0.05. The analysis of subgroup patients with relapsed/refractory showed haplo-cord HSCT was associated with better OS (HR 0.348, 95% CI, 0.175–0.691; p=0.0025), DFS (HR 0.402, 95% CI, 0.208–0.779; p=0.0069), and GRFS (HR 0.235, 95% CI, 0.120–0.457, p<0.0001) compared to the single cord group. The 2-year’s probability in OS, DFS, and GRFS was 64.9 vs. 31.6%, 64.5 vs. 31.6%, and 60.8 vs. 15.0% in the haplo-cord group and single cord group, respectively. III-IV acute GVHD 8.3 vs. 6.2%, chronic GVHD 25.8 vs. 13.7%, and extensive chronic GVHD 5.3 vs. 1.8% were shown in corresponding group, p>0.05. The patients engrafted persistently with UCB showed better survival outcomes. Our sequential Haplo-cord HSCT with ATG/PTCY improved the survival of patients and might be an alternative transplantation approach for patients with relapsed/refractory hematologic malignancies. Frontiers Media S.A. 2021-11-04 /pmc/articles/PMC8599442/ /pubmed/34804017 http://dx.doi.org/10.3389/fimmu.2021.733326 Text en Copyright © 2021 Li, Li, Chen, Li, Chen, Zhu, Wang, Huang, Chen, Chen and Li https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Li, Hua
Li, Xiaofan
Chen, Yiling
Li, Duihong
Chen, Xianling
Zhu, Zhijuan
Wang, Yiting
Huang, Jiafu
Chen, Ping
Chen, Yuanzhong
Li, Nainong
Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies
title Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies
title_full Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies
title_fullStr Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies
title_full_unstemmed Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies
title_short Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies
title_sort sequential transplantation of haploidentical stem cell and unrelated cord blood with using atg/ptcy increases survival of relapsed/refractory hematologic malignancies
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599442/
https://www.ncbi.nlm.nih.gov/pubmed/34804017
http://dx.doi.org/10.3389/fimmu.2021.733326
work_keys_str_mv AT lihua sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT lixiaofan sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT chenyiling sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT liduihong sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT chenxianling sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT zhuzhijuan sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT wangyiting sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT huangjiafu sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT chenping sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT chenyuanzhong sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies
AT linainong sequentialtransplantationofhaploidenticalstemcellandunrelatedcordbloodwithusingatgptcyincreasessurvivalofrelapsedrefractoryhematologicmalignancies