Combined Haploidentical and Umbilical Cord Blood Allogeneic Stem Cell Transplantation for High-Risk Lymphoma and Chronic Lymphoblastic Leukemia

摘要: Abstract Limited studies have reported on outcomes for lymphoid malignancy patients receiving alternative donor allogeneic stem cell transplants. We previously described combining CD34-selected haploidentical grafts with umbilical cord blood (haplo-cord) to accelerate neutrophil and platelet engraftment. Here, we examine the outcome of malignancies undergoing haplo-cord transplantation at University Chicago Weill Cornell Medical College. analyzed 42 lymphoma chronic lymphoblastic leukemia (CLL) who underwent transplantation. Patients transplant Hodgkin (n = 9, 21%), CLL (n = 5, 12%) non-Hodgkin lymphomas (n = 28, 67%), including 13 T lymphomas. Twenty-four (52%) had 3 or more lines therapies. Six (14%) 1 (2%) prior autologous transplant, respectively. At time 12 (29%) were in complete remission, 18 chemotherapy-sensitive disease, chemotherapy-resistant disease. Seven (17%), 11 (26%), 24 (57%) low, intermediate, high disease risk index before transplant. Comorbidity was evenly distributed among groups, (31%), 14 (33%), 15 (36%) scoring 0, 2, ≥3. Median age cohort 49 years (range, 23 71). All received fludarabine/melphalan/antithymocyte globulin conditioning regimen post-transplant graft-versus-host (GVHD) prophylaxis tacrolimus mycophenolate mofetil. The median engraftment days 9 60) 19.5 88). Cumulative incidence nonrelapse mortality 11.6% 100 19 % one year. relapse 9.3% 19% With a follow-up survivors months, 3-year rates GVHD free survival, progression-free overall survival 53%, 62%, 65%, respectively, these patients. Only 8% GVHD. In conclusion, offers recurrent refractory lack matching donors. Both count recovery is rapid, limited, excellent control can be achieved, limited. Thus, achieves encouraging results.