Haploidentical hematopoietic stem cell transplantation with supplemental umbilical cord blood infusion in treatment of malignant hematological diseases

Abstract

Objective To evaluate the efficacy of haploidentical hematopoietic stem cell transplantation (HSCT) with supplemental umbilical cord blood (UCB) infusion in treatment of malignant hematological diseases. Method Clinical data of 66 patients with hematological malignancies treated with HSCT in our hospital between January 2010 and May 2013, were retrospectively analyzed. Among them 25 cases received infusion of human UCB before HSCT (experimental group) and other 41 cases had no UCB injection before HSCT (control group). Results There were no differences in age, gender, donor type, disease categories, disease status before transplant between two groups (P>0.05). There was a significant difference in conditioning regimes between two groups (P<0.05), but no clinical implication. The infused mononuclear cell (MNC) count in experimental group was higher than that in control group (9.94±2.88×108/kg vs. 7.80±0.82×108/kg, P=0.00), while there were no difference in infused CD34+ cell count (5.46±3.54×106/kg vs. 3.54±1.60×106/kg, P=0.16). Neutrophil recovery time in experimental group was shorter than that in control group (13.7±2.9 d vs. 16.6±2.9 d, P=0.023). The incidences of grade Ⅲ-Ⅳ acute graft versus host disease (aGVHD, P=0.036), bacterial infection(P=0.001)and fungal infection(P=0.001)and hemorrhagic cystitis (P=0.00)in experimental group were lower than those in control group. There were no significant differences in platelet recovery time(P=0.43), the incidence of grade Ⅰ-Ⅱ aGVHD(P=0.27), implanted syndrome(P=0.24), sinusoidal obstruction syndrome(P=0.57)and viraemia(P=0.31)between two groups. Conclusion HSCT with supplemental infusion of human UCB may alleviate the degree of aGVHD, but the long-term outcome remains to be studied. Key words: Hematopoietic stem cell transplantation; Fetal blood; Hematologic neoplasms