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Comparison of clinical outcomes between unrelated single umbilical cord blood and"ex-vivo"T-cell depleted haploidentical transplantation in children with hematological malignancies

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World Journal of Pediatrics 2021年第6期17卷 609-618页

作者： Carmen Gomez-Santos Marta Gonzalez-Vicent Blanca Molina natalia deltoro Blanca Herrero Julia Ruiz Antonio Perez-Martinez Miguel A Diaz Department of Pediatrics Hematopoietic Stem Cell Transplantation UnitHospital Infantil Universitario"Nino Jesus"Menedez Pelayo 6528009 MadridSpain Hospital Infantil Universitario"La Pa"Madrid MadridSpain

Background Over the last two decades,umbilical cord blood(UCB)and haploidentical transplantation(HaploHSCT)have emerged as alternative sources of hematopoietic stem cell for allogeneic *** are few retrospective studies and no prospective studies comparing both types of alternative transplantation in pediatric *** We analyzed the data of 134 children with hematological malignancies who received a hematopoietic stem cell transplantation from a single umbilical cord blood(UCB)(n=42)or an"tex-vivo"T-cell depleted transplant from a haploi-dentical-related donor(HaploHSCT)(n=92)between 1996 and *** recovery was faster after HaploHSCT than the UCB transplant group(median times to neutrophil and platelet recovery:13 vs.16 days,10 vs.57 days,respectively)(P<0.001).The HaploHSCT group had a significantly early immune reconstitution based on NK and CD8+T cells compared with the UCB ***,after the first year *** had a lower number of CD4+ T and B lymphocytes compared with the UCB transplant *** cumulative incidence of TRM was 29±8%in the HaploHSCT group versus 40±5%in the UCB *** incidence was 21±7%in the HaploHSCT group and 19±8%in the UCB *** of DFS was 58±8%in the HaploHSCT group versus 40±9%in the UCB group(P=0.051).Conclusions TCD haploidentical transplant is associated with advantages in terms of engraftment and early immune reconstitution *** haploidentical transplant was associated with lower incidence of infectious and non-infectious complications,especially in the early phases of the transplant compared with UCB transplant ***,there are no advantages in transplant outcomes compared with UCB transplant.

关键词： Children Cord blood transplant Hematologic malignancies Immune reconstitution TCD haploidentical transplant

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