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...
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oai:doaj.org-article:573623544e75498bb1e069ed37bfa5462021-11-04T05:48:42ZSequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies1664-322410.3389/fimmu.2021.733326https://doaj.org/article/573623544e75498bb1e069ed37bfa5462021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fimmu.2021.733326/fullhttps://doaj.org/toc/1664-3224Allogeneic 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.Hua LiXiaofan LiXiaofan LiYiling ChenDuihong LiXianling ChenZhijuan ZhuYiting WangJiafu HuangPing ChenYuanzhong ChenYuanzhong ChenNainong LiNainong LiFrontiers Media S.A.articlesequential transplantationrelapsed/refractory hematologic malignanciespost-transplant cyclophosphamideumbilical cord blood transplantationlow-dose ATGImmunologic diseases. AllergyRC581-607ENFrontiers in Immunology, Vol 12 (2021) |
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| collection |
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| topic |
sequential transplantation relapsed/refractory hematologic malignancies post-transplant cyclophosphamide umbilical cord blood transplantation low-dose ATG Immunologic diseases. Allergy RC581-607 |
| spellingShingle |
sequential transplantation relapsed/refractory hematologic malignancies post-transplant cyclophosphamide umbilical cord blood transplantation low-dose ATG Immunologic diseases. Allergy RC581-607 Hua Li Xiaofan Li Xiaofan Li Yiling Chen Duihong Li Xianling Chen Zhijuan Zhu Yiting Wang Jiafu Huang Ping Chen Yuanzhong Chen Yuanzhong Chen Nainong Li Nainong Li Sequential Transplantation of Haploidentical Stem Cell and Unrelated Cord Blood With Using ATG/PTCY Increases Survival of Relapsed/Refractory Hematologic Malignancies |
| 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 |
article |
| author |
Hua Li Xiaofan Li Xiaofan Li Yiling Chen Duihong Li Xianling Chen Zhijuan Zhu Yiting Wang Jiafu Huang Ping Chen Yuanzhong Chen Yuanzhong Chen Nainong Li Nainong Li |
| author_facet |
Hua Li Xiaofan Li Xiaofan Li Yiling Chen Duihong Li Xianling Chen Zhijuan Zhu Yiting Wang Jiafu Huang Ping Chen Yuanzhong Chen Yuanzhong Chen Nainong Li Nainong Li |
| author_sort |
Hua Li |
| title |
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_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_sort |
sequential transplantation of haploidentical stem cell and unrelated cord blood with using atg/ptcy increases survival of relapsed/refractory hematologic malignancies |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/573623544e75498bb1e069ed37bfa546 |
| work_keys_str_mv |
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