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Retrospective cohort study comparing the outcomes of intravenous busulfan vs. total-body irradiation after single cord blood transplantation

Bone Marrow Transplantation volume 54, pages 1614–1624 (2019)Cite this article

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Abstract

Limited to inadequate stem-cell doses, cord blood transplantation (UCBT) is accompanied by increased graft failure and delayed haematopoietic recovery. The conditioning regimen is critically important for engraftment, and numerous trials have been undertaken comparing the outcomes of IV Bu and TBI, but there are no comparative data for UCBT. We conducted a retrospective multicentre study to analyse the outcomes of IV Bu and TBI in UCBT patients with haematologic malignancies. Between 1 May, 2008 and 31 Mar, 31 2018, a total of 331 patients from the China Umbilical Cord Blood Transplantation Corporation (IV Bu, n = 131; TBI, n = 200) were evaluated. The cumulative incidence of neutrophil engraftment was 91.6% in the IV Bu/Cy cohort and 98.0% in the Cy/TBI cohort (P < 0.001). The median times to neutrophil engraftment were 16 and 19 days (P < 0.001), respectively. Multivariate analysis showed no statistical difference for nonrelapse mortality (hazard ratio [HR], 1.11; 95% confidence interval [CI], 0.66 to 1.86; P = 0.695), relapse (HR, 0.90; 95% CI, 0.50 to 1.60; P = 0.713) and overall survival (HR, 0.94; 95% CI, 0.61 to 1.44; P = 0.763) between the two conditioning regimens. Our results show that both IV Bu and TBI are valid myeloablative conditioning regimens for haematologic malignancy patients treated with UCBT.

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Acknowledgements

We thank American Journal Experts for their assistance in editing this manuscript. We thank all China Umbilical Cord Blood Transplantation Corporation centres and national registries for contributing patients to the study and data managers for their superb work. This work was supported by grants from the National Natural Science Foundation of China (No. 81670165 and 81470350).

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  1. These authors contributed equally: Baolin Tang, Xiaoyu Zhu

Authors and Affiliations

  1. Shandong University School of Medicine, Jinan, China

    Baolin Tang, Wen Yao, Kaidi Song, Xuhan Zhang, Xiang Wan & Zimin Sun

  2. Department of Haematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China

    Baolin Tang, Xiaoyu Zhu, Changcheng Zheng, Huilan Liu, Liangquan Geng, Kaiyang Ding, Xingbing Wang, Wen Yao, Xuhan Zhang, Xiang Wan, Lei Zhang, Juan Tong, Guangyu Sun, Yun Wu & Zimin Sun

  3. Department of Haematology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Siguo Hao

  4. Department of Haematology, The First Affiliated Hospital of Wannan Medical College, Wuhu, China

    Dongping Huang & Zhonglin Wei

  5. Department of Haematology, Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China

    Dongjun Lin

  6. Department of Haematology, Fujian Medical University Union Hospital, Fuzhou, China

    Nainong Li

  7. Department of Haematology, The First Hospital of Jilin University, Changchun, China

    Sujun Gao & Xiaoliang Liu

  8. Department of Haematology, Chenzhou No. 1 People’s Hospital, Chenzhou, China

    Xinquan Liang

  9. Institute of Haematology, Anhui Medical University, Hefei, China

    Jianjun Li & Lulu Huang

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Tang, B., Zhu, X., Zheng, C. et al. Retrospective cohort study comparing the outcomes of intravenous busulfan vs. total-body irradiation after single cord blood transplantation. Bone Marrow Transplant 54, 1614–1624 (2019). https://doi.org/10.1038/s41409-019-0441-4

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