Abstract：
Chronic myelomonocytic leukaemia (CMML) is a haematological malignancy with a poor prognosis. Allogeneic haematopoietic stem cell transplantation remains the only curative approach. Without human leucocyte antigen-matched related sibling donors, the optimal alternative donor has yet to be established. Although unrelated bone marrow transplantation (UBMT) has been extensively studied, cord blood transplantation (CBT) for CMML remains largely unexplored. This nationwide retrospective study compared the outcomes of UBMT and single-unit umbilical CBT in patients with CMML. This study included 118 patients who underwent their first allo-HSCT during 2013-2021. Of these, 50 received BMT (UBMT group), while 68 underwent CBT (CBT group). The primary endpoint was the 3-year overall survival (OS). There were comparable 3-year OS rates between the UBMT (51.0%, 95% confidence interval [CI]: 34.1-65.5%) and CBT (46.2%, 95% CI: 33.2-58.1%; P = 0.60) groups. In the inverse probability of treatment weighting analysis, CBT did not show significantly improved outcomes compared with UBMT regarding the 3-year OS rate (hazard ratio 0.97 [95% CI: 0.57-1.66], P = 0.91). Thus, CBT may serve as an alternative to UBMT for patients with CMML. Further research is necessary to optimise transplantation strategies and enhance outcomes in patients with CMML undergoing CBT.
摘要：
慢性粒单核细胞白血病（CMML）是一种预后不良的血液系统恶性肿瘤。异基因造血干细胞移植仍然是唯一的治愈方法。没有人类白细胞抗原匹配的同胞供体，最佳替代捐赠者尚未建立。尽管无关骨髓移植（UBMT）已经被广泛研究，CMML的脐带血移植（CBT）仍未被探索。这项全国性的回顾性研究比较了CMML患者UBMT和单单位脐带CBT的结果。这项研究包括118名患者，他们在2013-2021年期间接受了他们的第一次allo-HSCT。其中,50例接受BMT（UBMT组），68例接受了CBT（CBT组）。主要终点是3年总生存期（OS）。UBMT之间的3年OS率相当(51.0%，95%置信区间[CI]：34.1-65.5%)和CBT(46.2%，95%CI：33.2-58.1%；P=0.60）组。在治疗权重分析的逆概率中，与UBMT相比，CBT在3年OS率方面没有显着改善（风险比0.97[95％CI：0.57-1.66]，P=0.91）。因此，对于CMML患者，CBT可以替代UBMT。需要进一步的研究来优化移植策略并提高接受CBT的CMML患者的预后。
