title: [A comparison of clinical outcomes between unrelated donor and HLA-haploidentical donor hematopoietic stem cell transplantation].
abstract: OBJECTIVE
  To compare the clinical outcomes between unrelated donor hematopoietic stem cell transplantation (URD-HSCT) and HLA-haploidentical (Hi)-HSCT.
  
  
  METHODS
  Twenty-five patients with hematologic malignancies received URD-HSCT and thirty patients received Hi-HSCT. The conditioning regimen consisted of modified BUCY or modified total body irradiation (TBI) plus CY. Acute graft-versus-host disease (aGVHD) prophylaxis consisted of cyclosporin ( CsA), short-term methotrexate (MTX), mycophenolate mofetil (MMF), or the combination of CsA, MTX and MMF plus antithymocyte globulin (ATG) or antilymphocyte globulin (ALG), or the combination of CsA, MTX, MMF, ATG/ ALG and CD25 monoclonal antibody.
  
  
  RESULTS
  All patients in the URD-HSCT group and 29 patients in the Hi-HSCT group were engrafted successfully. The median follow-up duration was 7 (2 -59) months for URD-HSCT group and 7.3 (1 - 35) months for Hi-HSCT group. The 3-year probabilities of disease-free survival (DFS) for URD-HSCT and Hi-HSCT group were (54.1 +/- 11.9)% and (43.1 +/- 9.1)%, respectively (P =0.13). Grade III - IV aGVHD occurred in 10 patients in URD-HSCT group and 11 in Hi-HSCT group (the cumulative incidence 40.0% vs 37.9%, P > 0.05), respectively. Ten patients (40.0%) died of transplantation-related mortality (TRM) in URD-HSCT group and 17 (56.7%) in Hi-HSCT group (P >0. 5). Two patients relapsed in each group (the rate of relapse 8.0% vs 6.0%, P >0.05). The primary causes of death included severe aGVHD with infection,severe pulmonary infection and relapse.
  
  
  CONCLUSIONS
  Both URD-HSCT and Hi-HSCT are effective and curable treatment for refractory or high-risk hematologic malignancies. The optimal donor should be chose individually. The severe aGVHD and consequent infection are still the main cause of TRM.
authors.affiliation: Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou 215006, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.forename: De-Pei
authors.initials: DP
authors.lastname: Wu
authors.forename: Ai-Ning
authors.initials: AN
authors.lastname: Sun
authors.forename: Xiao
authors.initials: X
authors.lastname: Ma
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Tang
authors.forename: Hui-Ying
authors.initials: HY
authors.lastname: Qiu
authors.forename: Miao
authors.initials: M
authors.lastname: Miao
authors.forename: Zheng-Zheng
authors.initials: ZZ
authors.lastname: Fu
authors.forename: Zheng-Ming
authors.initials: ZM
authors.lastname: Jin
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiao-Jin
authors.initials: XJ
authors.lastname: Wu
authors.forename: Su-Ning
authors.initials: SN
authors.lastname: Chen
authors.forename: Guang-Sheng
authors.initials: GS
authors.lastname: He
authors.forename: Xiu-Li
authors.initials: XL
authors.lastname: Wang
authors.forename: Sheng-Li
authors.initials: SL
authors.lastname: Xue
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhao
authors.forename: Wei-Rong
authors.initials: WR
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D055815:Young Adult