| ObjectiveTo study the clinical efficacy of single umbilical cord blood transplantation for the treatment of malignant hematopathy and the clinical efficacy of allogeneic bone marrow-derived stem cell transplantation MethodsA total of 81 patients with hematological malignancies who underwent hematopoietic stem cell transplantation were followed up,including 33 of AML,33 of ALL,10 of NHL,and 5 of CML.All patients were divided into two groups by the stem cell source: UCBT group and the rest were divided into BMT group.The a GVHD?c GVHD?no relapse mortality?relapse mortality?OS?DFS?GRFS and safe were evaluated in both groups..Results1.The median follow-up time for patients receiving UCBT was 8.3(0.1-43.6)months,BMT was(0.8-48)months(P=0.087).The HLA of BMT was better than UCBT(P <0.001).2.UCBT and BMT were compared in CD34 + cell infusion(median 0.17 ×106 / Kg vs.5.8 × 106 / Kg,P <0.001)?neutrophil implantation time(median 18 days vs.15 days,P = 0.297)and platelet implantation time(median 33 days vs.15 days,P = 0.767).3.Comparing UCBT and BMT,the cumulative incidence of grade?-? acute GVHD for three yearswas(23.5% vs.43.2%,P=0.110),and the cumulative incidence of grade?-?acute GVHD for three years was(0 vs.17.4%,P=0.029);The cumulative incidence of limited chronic GVHD was(5.0% vs.17.3%,P=0.262)at the end of the third year;the cumulative incidence of generalized extensive chronic GVHD in the past three years was(9.1% vs.46.4%,P=0.042).4.Comparing UCBT and BMT,the OS of UCBT for three years was better,(64.5% vs.56.5%,P=0.623),but no statistically significant difference;the DFS of UCBT for three years was better,(64.4% vs.50.0%,P=0.998),but no statistically significant difference;GRFS of UCBT was better,(61.4% vs.22.3%,P= 0.055),in the past three years,but no statistically significant difference.5.The remission patients who were treated with UCBT and BMT,the OS for three years was(85.9% vs.64.9%,P=0.396);the DFS for three years was(85.9% vs.57.9%,P=0.225);the GRFS of UCBT for three years was(80.2% vs.26.3%,P=0.008).6.The non-mission patients who were treated with UCBT and BMT,OS for one year was(38.5% vs.56.3%,P=0.217);DFS for one year was better,(38.5% vs.50%,P=0.368),GRFS for one year was(38.5% vs.25%,P=0.943).7.The risk ratio of UCBT and BMT about OS,DFS,GRFS was OS(HR =1.298;95% CI,0.584-2.887;P = 0.522),DFS(HR =(1.049;95% CI,0.486-0.76;P = 0.904)and GRFS(0.537;95% CI,0.271-1.063;P = 0.074);It was no statistically significant difference.8.The no relapse mortality of UCBT and BMT was(27.6% vs.21.1%,p=0.265),The relapse mortality of UCBT and BMT was(10.9% vs.28.3%,p=0.603);It was no statistically significant difference.9.The rate of cytomegalovirus infection was(80.00% vs.52.94%,P <0.001),.ConclusionThe clinical efficacy of umbilical cord blood transplantation is not inferior to that of bone marrow transplantation,and the incidence of severe acute graft-versus-host disease and extensive chronic GVHD was low.The remission patients who were treated with umbilical cord blood transplantation had better quality of life. |
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