Myeloablative conditioning regimens with combined of haploidentical and cord blood transplantation for myelodysplastic syndrome patients

• Published in: Bone marrow transplantation (Basingstoke) Vol. 53; no. 2; pp. 162 - 168
• Main Authors: Ke, P, Bao, X-B, Hu, X-H, Zhuang, J, Wu, X-J, Liu, Y-J, He, X-F, Wu, D-P, Xue, S-L, Ma, X
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2018; Nature Publishing Group
• Subjects: 13/100; 631/532/1542; 692/699/1541/1990/1673; Adolescent; Adult; Blood; Blood transfusion; Care and treatment; Cell Biology; Child; Cord blood; Cord Blood Stem Cell Transplantation - methods; Diagnosis; Disease-Free Survival; Female; Fetal blood; Graft-versus-host reaction; Health aspects; Hematology; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Myelodysplastic syndrome; Myelodysplastic syndromes; Myelodysplastic Syndromes - pathology; Myelodysplastic Syndromes - therapy; original-article; Patients; Public Health; Stem cell transplantation; Stem Cells; Survival; Transplantation; Transplantation Conditioning - methods; Transplants & implants; Umbilical cord; Young Adult
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2017.229

The purpose of this study was to evaluate the strategy of haploidentical (HID) stem cell combined with a small doses of umbilical cord blood (UCB) from a third-party donor transplantation (haplo-cord transplant) for treatment of myelodysplastic syndromes (MDS), by comparing with identical-sibling donor (ISD) transplantation. Eighty-five patients were included between January 2012 and December 2015, with a median 40 years old. Forty-eight patients received haplo-cord transplant and 37 patients received ISD transplant. Haplograft engraftment succeeded in all haplo-cord patients. For haplo-cord and ISD transplantation, adjusted cumulative incidences of grades 2–4 acute GvHD at 100 days were 27 and 11% ( P =0.059); adjusted cumulative incidences of chronic GvHD at 2 years were 22 and 34% ( P =0.215). The 2-year adjusted probabilities of overall survival were 64 and 70% ( P =0.518), and of relapse-free survival were 56 and 66% ( P =0.306). The 2-year adjusted cumulative incidences of relapse were 12 and 14% ( P =0.743), and of non-relapse mortality were 33 and 23% ( P =0.291). In conclusion, haplo-cord-HSCT achieves outcomes similar to those of ISD-HSCT for MDS and the haplo-cord-HSCT may potentially improve the outcome of HID- and UCB-HSCT alone. Thus, the haplo-cord transplantation may be a better valid alternative for MDS when an ISD is not available.