Abstract:
Objective: To comparatively analyze clinical efficacy of single- unit and double- unit nonrelative cord blood transplantation for treatment of hematologic diseases. Methods: Clinical data of the 185 patients received single-unit umbilical cord blood transplantation (SU-UCBT) and the 66 patients received double-unit umbilical cord blood transplantation (DU-UCBT) in 8 domestic transplant centers during 2006 to 2016 were retrospectively analyzed.It was compared that implantation rates, implantation time of neutrophil granulocyte and platelet between SUUCBT and DU-UCBT, as well as occurrence of acute graft vs host disease (aGVHD) and survival rates of the patients with malignant hematonosis and with non malignant hematonosis after SU-UCBT and DU-UCBT. Results:Implantation rates of the patients received SU-UCBT and DU-UCBT were 78.9% and 70.7% respectively, among them implantation rates of the patients with malignant hematonosis were 89.1% for SU-UCBT and 82.5% for DUUCBT as well as implantation rates of the patients with non malignant hematonosis were 64.0% for SU-UCBT and 53.8% for DU-UCBT, implantation rates of SU-UCBT and DU-UCBT were similar (P>0.05). In the patients received SU-UCBT and DU-UCBT, median implantation times of neutrophil granulocyte were all 18 d, median implantation times of platelet were 40 d and 27 d respectively, the difference was not remarkable (P>0.05). Incidence rates of aGVHD at I, II, III, IV grades in the patients received SU-UCBT and DU-UCBT were 22.6%, 22.6%, 8.2%,12.3% and 21.3%, 14.9%, 10.6%, 10.6% respectively, all of the differences were not evident (all P>0.05). Median survival time in the recipients of SU-UCBT and DU-UCBT were 1 460 d (17~2 200 d) and 988 d (21~2 200 d), and their cumulative survival rate of 6 years were respectively 42.5% and 40.4%, all differences were not obvious (P>0.05). Conclusion: Between the patients successfully received SU-UCBT and DU-UCBT, implantation times of neutrophil granulocyte and platelet, incidence rate of aGVHD, survival time and cumulative survival rate of 6 years were not significant, which suggests that DU-UCBT could be a safe and effective selection of UCBT. However, the evaluation system of SU-UCBT and DU-UCBT still needs to be perfected and implantation mechanism of DUUCBT needs to make a thorough inquiry, so as to scientifically guide selection of UCBT.