The efficacy and safety of third-party umbilical blood/umbilical cord mesenchymal stem cell assisted related haploid hematopoietic stem cell transplantation in pediatric patients with acute leukemia: an observational study.

IF 3.4 3区 医学 Q2 HEMATOLOGY Therapeutic Advances in Hematology Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI:10.1177/20406207241277549
Chang Liu, Minyuan Liu, Xin Liu, Bohan Li, Li Gao, Shuiyan Wu, Qi Ji, Zhiqi Zhang, Senlin Zhang, Peifang Xiao, Jun Lu, Jie Li, Shaoyan Hu
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Abstract

Background: There is limited data on third-party umbilical cord blood (UCB) or mesenchymal stem cell (MSC) transplantation-assisted haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in pediatric patients.

Objective: To evaluate the efficacy and safety of UCB and MSC transplantation-assisted haplo-HSCT in pediatric patients with acute leukemia (AL).

Design: Observational study.

Methods: Clinical data of 152 children with AL undergoing haplo-HSCT at the Children's Hospital of Soochow University between January 2020 and June 2022 were collected. The patients were divided into the haplo-HSCT + UCB group (n = 76), haplo-HSCT + MSC group (n = 31), and haplo-HSCT group (n = 45). Hematopoietic reconstruction time, complications within 30 days after transplantation, and survival and recurrence at 3 years after transplantation were compared among the groups.

Results: Multivariate analysis revealed that haplo-HSCT with MSC and human leukocyte antigen (HLA) matching ⩾6/10 were independent factors reducing engraftment syndrome (ES) incidence. There were no significant differences among the groups in the hematopoietic reconstruction time or incidence of complications within 30 days after transplantation (p > 0.05). Overall survival, relapse-free survival, cumulative incidence of relapse, cumulative incidence of hematological relapse, and 3-year transplant-related mortality were not significantly different (p > 0.05). The incidence of adverse reactions in the haplo-HSCT + UCB group was 97.3% within 4 h after UCB infusion, with a particularly high occurrence rate of 94.7% for hypertension. No transfusion-related adverse reactions occurred after the transfusion of umbilical cord MSC in the haplo-HSCT + MSC group.

Conclusion: MSC-assisted haplo-HSCT can reduce ES incidence after transplantation in pediatric patients with AL. UCB infusion is associated with a high incidence of reversible hypertension. However, no adverse reactions were observed in umbilical cord MSC transfusion.

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儿科急性白血病患者接受第三方脐血/脐带间充质干细胞辅助相关单倍体造血干细胞移植的有效性和安全性:一项观察性研究。
背景:第三方脐带血(UCB)或间充质干细胞(MSC)移植辅助单倍体造血干细胞移植(haplo-HSCT)在儿科患者中的应用数据有限:评估UCB和间充质干细胞移植辅助单倍体造血干细胞移植治疗儿童急性白血病(AL)患者的有效性和安全性:设计:观察性研究:收集2020年1月至2022年6月期间在苏州大学附属儿童医院接受单倍体造血干细胞移植的152名AL患儿的临床数据。患者分为单倍体-HSCT+UCB组(n=76)、单倍体-HSCT+间充质干细胞组(n=31)和单倍体-HSCT组(n=45)。比较了各组的造血重建时间、移植后30天内的并发症、移植后3年的存活率和复发率:多变量分析显示,使用间充质干细胞的单倍体造血干细胞移植和人类白细胞抗原(HLA)匹配度⩾6/10是降低移植综合征(ES)发生率的独立因素。各组在造血重建时间或移植后 30 天内并发症发生率方面无明显差异(P > 0.05)。总生存率、无复发生存率、累积复发率、累积血液病复发率和3年移植相关死亡率无明显差异(P > 0.05)。单倍体-HSCT+UCB组在输注UCB后4小时内的不良反应发生率为97.3%,其中高血压的发生率尤其高,为94.7%。单倍体-HSCT+间充质干细胞组在输注脐带间充质干细胞后未发生输血相关不良反应:结论:间充质干细胞辅助的单倍体-HSCT可降低AL儿童患者移植后ES的发生率。UCB输注与可逆性高血压的高发生率有关。然而,脐带间充质干细胞输注未出现不良反应。
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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
54
审稿时长
7 weeks
期刊介绍: Therapeutic Advances in Hematology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of hematology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in hematology, providing a forum in print and online for publishing the highest quality articles in this area.
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