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A metaanalysis of unrelated cord blood transplantation versus HLAmismatched unrelated donor transplantation in hematological malignancies

  

  1. 1.Medical School of Ningbo University,Ningbo 315000,China; 2.Department of Hematology,
    Yinzhou Hospital Affiliated to Medical School of Ningbo University,Ningbo 315040,China
  • Online:2018-03-05 Published:2018-03-19
  • Contact: Corresponding author:Lu Ying,Email:yuhanyang_01@aliyun.com

Abstract: Objective  To compare the efficacy of  unrelated cord blood transplantation(UCBT) and human leukocyte antigen mismatched unrelated donor transplantation(HLAMMUDT) in treatment of adult hematological  malignancies.Methods  Published studies of UCBT and MMUDT were collected from PubMed,EMBASE,Cochrane Central Register of Controlled Trials(CENTRAL) of the Cochrane Library,China Biology Medicine(CBM),China National Knowledge Infrastructure(CNKI),WANFANG database and VIP information.References of retrieved articles were also identified.Data analysis was performed with RevMan5.3.Results  Seven studies were selected,which included   1 275  patients treated with UCBT  and  751 patients treated with MMUDT.Metaanalysis results showed that the incidence of acute graftversushost disease and chronic graftversushost disease in UCBT group was significantly lower than MMUDT group(RR=0.89,95%CI=0.800.99,P=0.03;RR=0.63,95%CI=0.500.79,P<0.01).However, infectionrelated mortality in UCBT group was significantly higher than  MMUDT group(RR=1.23,95%CI=1.051.46,P=0.01).There was no significant difference in relapse,transplantationrelated mortality,overall survival and disease free survival between two groups,respectively(RR=0.85,95%CI=0.651.11,P=0.23; RR=0.95,95%CI=0.781.17,P=0.51; HR=1.01,95%CI=0.901.13,P=0.87;HR=1.04,95%CI=0.911.20,P=0.56). Conclusion  UCBT and MMUDT had emerged as an effective stem cell source to treatment hematological malignancies for  patients lacked of HLAmatched related or unrelated donor. MMUDT had a certain advantage for the patients who had the greater risk of infection and lacked of HLAmatched donor compared with UCBT.

Key words: cord blood stem cell transplantation, mismatched unrelated donor transplantation, hematologic neoplasms, metaanalysis