| Objective:It mainly analyzes the umbilical cord blood used in single-unit umbilical cord blood transplantation(sUCBT),which is provided by China's public cord blood bank.It made an analysis for the effect and safety of malignant hematologic diseases cured by UCBT.To explore quality-control system of umbilical cord blood in China's public cord blood bank.Method:We retrospectively analyzed 409 cases of patients with malignant hematologic diseases who accepted myeloablative single-unit unrelated donor UCBT without ATG at our center between May 2008 and December 2016.It made a comparative analysis for the umbilical cord blood's total nucleated cell(TNC)before freezing and after thawing,the cells of CD34+,the recovery rate of cells and the clinical effect of UCBT.Result:1)A total of 409 sUCBT cases were collected from 2008 to 2016,including ALL 193patients(47.2%),AML 140 patients(34.2%),CML 28 patients(6.8%),MDS25patients(6.1%),CMML/JMML each 1 patients(0.05%),ML 9 patients(2.2%),Others 12 patients(2.9%);409 units of umbilical cord blood used in UCBT respectively came from eight China's public cord blood banks,the number of sUCBT cases increased year by year from 2008 to 2016.2)The average of 409 units of umbilical cord blood's TNC before freezing and after the tubularrecoverywererespectively18.5×10~8(16.6×10~8-20.6×10~8)?16.34×10~8(15.29×10~8-19.6×10~8)(P=0.000).The average recovery rate of the tubular recovery was 88.5%,and the difference of recovery rate in each bank was obvious statistically significant(P=0.000).The average of umbilical cord blood's TNC before freezing and transfusion were respectively 18.5×10~8,15.86×10~8(14.5×10~8-19.6×10~8)(P=0.000).The average recovery rate of umbilical cord blood transfusion was 85.9%,and the difference of recovery rate in each bank was obvious statistically significant(P=0.000).There was no statistical significance(P=0.898)between umbilical cord blood's TNC after the tubular recovery and transfusion.3)The average of CD34+cells before freezing and after the tubular recovery were11.18×10~6(6.0×10~6-13.01×10~6),8.68×10~6(4.16×10~6-10.28×10~6).The average recovery rate of CD34+cells after the tubular recovery was 80.75%,and the difference of the recovery rate in each bank was obvious statistically significant(P=0.000).4)During 42 days when 409 patients made the UCBT,the cumulative incidence of neutrophil engraftment was 95.4%,it had the engraftment median time of 17d(11d-38d).The cumulative incidence of platelet engraftment during 120 days was 84.6%,it had the engraftment median time of 36d(14d-93d).The cumulative incidence of erythrocyte engraftment during 60 days was 92%,it had the engraftment median time of 22d(9d-60d).After umbilical cord blood provided by each bank was used in UCBT,it got the difference about cumulative incidence of engraftment.The P values of neutrophil,platelet and erythrocyte were respectively 0.004,0.01 and 0.0002,the differences were obvious statistically significant.5)During 100 days after UCBT,the cumulative incidence about the?-?and?-?degrees of acute graft-versus-host disease(aGVHD)were respectively 28.63%and15.7%.After umbilical cord blood provided by each bank was used in UCBT,it got the difference about cumulative incidence of aGVHD.The P values of II-IV and III-IV degrees were 0.809 and 0.68,there was no statistical significance for the difference.During 3 years after UCBT,the cumulative incidence of relapse was 15.89%.After umbilical cord blood provided by each bank was used in UCBT,the difference about cumulative incidence of relapse was no statistical significance(P=0.898).During 3years after UCBT,the overall survival(OS)rate and disease free survival(DFS)rate were respectively 66.7%and 59%.After umbilical cord blood provided by each bank was used in UCBT,it got the difference about OS and DFS.The P values of OS and DFS were respectively 0.566 and 0.703,there was no statistical significance for the difference.During 3 years after sUCBT,the rate of graft-versus-host diseases/relapse-free survival(GRFS)was 54.3%.After umbilical cord blood provided by each bank was used in UCBT,the difference about the rate of GRFS was no statistical significance(P=0.449).Conclusion:Recently,the hospitalization of sUCBT in Anhui Provincial Hospital showed an overall trend of increase.In particular,the number of hospitalized patients with sUCBT increased significantly in recent 5 years.The umbilical cord blood provided by China's public cord blood bank was used in UCBT.It has a high safety and good efficacy in treating malignant hematologic diseases.But it needs to set up the standardized and normalized quality-control system of umbilical cord blood for China's public cord blood bank. |
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