这项研究评估了供体骨髓(BM)增生程度对异基因造血干细胞移植(allo-HSCT)后患者临床结局的影响。在2010年1月至2017年12月期间,12名患者接受了来自发育不良BM供体的allo-HSCT。使用倾向评分匹配方法(1:4)选择了48名供体表现出BM增生的患者。两组均未发生原发性移植物衰竭,包括移植物功能差和移植物排斥反应。在BM发育不全和增生组中,第28天中性粒细胞植入的累积发生率(CI)(91.7%vs.93.8%,P=0.75),第150天血小板植入(83.3%vs.93.8%,P=0.48),髓样植入的中位时间(14天vs.14天,P=0.85)和血小板植入(14天vs.14天,P=0.85)具有可比性。3年无进展生存期,总生存率,非复发死亡率和复发的CI分别为67.8%和71.7%(P=0.98),69.8%与77.8%(P=0.69),18.5%vs.13.6%(P=0.66),和10.2%与10.4%(P=0.82),分别。在多变量分析中,供体BM发育不全不影响allo-HSCT后患者的临床结局.如果患者没有其他合适的捐赠者,如果供体全血细胞计数和其他检查正常,则BM发育不全的供体可用于接受allo-HSCT的患者。
This study evaluated the influence of the degree of donor bone marrow (BM) hyperplasia on patient clinical outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Twelve patients received allo-HSCT from hypoplastic BM donors between January 2010 and December 2017. Forty-eight patients whose donors demonstrated BM hyperplasia were selected using a propensity score matching method (1:4). Primary graft failure including poor graft function and graft rejection did not occur in two groups. In BM
hypoplasia and hyperplasia groups, the cumulative incidence (CI) of neutrophil engraftment at day 28 (91.7% vs. 93.8%, P=0.75), platelet engraftment at day 150 (83.3% vs. 93.8%, P=0.48), the median time to myeloid engraftment (14 days vs. 14 days, P=0.85) and platelet engraftment (14 days vs. 14 days, P=0.85) were comparable. The 3-year progression-free survival, overall survival, CI of non-relapse mortality and relapse were 67.8% vs. 71.7% (P=0.98), 69.8% vs. 77.8% (P=0.69), 18.5% vs. 13.6% (P=0.66), and 10.2% vs. 10.4% (P=0.82), respectively. In multivariate analysis, donor BM
hypoplasia did not affect patient clinical outcomes after allo-HSCT. If patients have no other suitable donor, a donor with BM
hypoplasia can be used for patients receiving allo-HSCT if the donor Complete Blood Count and other examinations are normal.