摘要
The effects of haploidentical rhG-CSF-mobilized blood and marrow transplantation(HBMT) on hematological malignances are well established. Previous prospective single-center studies have demonstrated better survival after HBMT versus haploidentical rhG-CSF-mobilized peripheral blood stem cell transplantation(HPBSCT) for acute leukemia(AL) not in remission(NR) or in more than the second complete remission(>CR2). To test the hypothesis that HBMT is still superior to HPBSCT for patients with AL, multiple myeloma(MM), or non-Hodgkin lymphoma(NHL) in CR1/CR2 and for patients with chronic myeloid leukemia in the first and second chronic phase lacking a matched donor, we designed a propensity score method-based multicenter study.Hematopoietic recovery, acute graft-versus-host disease(aGVHD), and chronic GVHD were comparable between the HBMT group(n=168) and the HPBSCT group(n=42). No significant differences were found in non-relapse mortality rate(20.17%±3.58%and 27.24%±7.16%, P=0.18) or relapse rate(19.96%±3.72% and 28.49%±8.25%, P=0.32) between the HBMT group and the HPBSCT group. HBMT recipients had better overall survival(65.0%±4.2% and 54.2%±8.3%, P=0.037) and disease-free survival(59.9%±4.6% and 44.3%±8.7%, P=0.051). Multivariate analysis showed that HPBSCT was associated with poorer DFS(HR(95%CI), 1.639(0.995–2.699), P=0.052). Our comparisons showed that HBMT was superior to HPBSCT as a post-remission treatment for patients lacking an identical donor.
The effects of haploidentical rhG-CSF-mobilized blood and marrow transplantation （HBMT） on hematological malignances are well established. Previous prospective single-center studies have demonstrated better survival after HBMT versus haploidentical rhG-CSF-mobilized peripheral blood stem cell transplantation （HPBSCT） for acute leukemia （AL） not in remission （NR） or in more than the second complete remission （〉CR2）. To test the hypothesis that HBMT is still superior to HPBSCT for patients with AL, multiple myeloma （MM）, or non-Hodgkin lymphoma （NHL） in CR1/CR2 and for patients with chronic myeloid leukemia in the first and second chronic phase lacking a matched donor, we designed a propensity score method-based multicenter study. Hematopoietic recovery, acute graft-versus-host disease （aGVHD）, and chronic GVHD were comparable between the HBMT group （n=168） and the HPBSCT group （n=42）. No significant differences were found in non-relapse mortality rate （20.17%±3.58% and 27.24%±7.16%, P=0.18） or relapse rate （19.96%±3.72% and 28.49%±8.25%, P=0.32） between the HBMT group and the HPBSCT group. HBMT recipients had better overall survival （65.0%±4.2% and 54.2%±8.3%, P=0.037） and disease-free survival （59.9%±4.6% and 44.3%±8.7%, P=0.051）. Multivariate analysis showed that HPBSCT was associated with poorer DFS （HR （95%CI）, 1.639 （0.995-2.699）, P=0.052）. Our comparisons showed that HBMT was superior to HPBSCT as a post-remission treatment for patients lacking an identical donor.
基金
supported by the National Natural Science Foundation of China(81530046,81270644,81230013)
the Major State Basic Research Development Program of China(2013CB733700)
the Collaborative Innovation Center of Hematology,Peking University,China,Beijing Talents fund(2015000021223ZK26)
the Milstein Medical Asian American Partnership(MMAAP)Foundation Research Project Award in Hematology
project TG-2015-003 supported by the Health Science Promotion Project of Beijing
