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Bone marrow transplantation is the only curable treatment for many blood diseases, but the difficulty of selecting transplanted donor is the main obstacle to transplantation.
two parallel phase II trials involving the transplantation of un kinship cord blood or bone marrow transplantation from HLA-monolithic combined donor directly compared the two donor sources.
June 2012-June 2018, a total of 368 patients with chemotherapy-sensitive lymphoma or leukemia in remission aged 18-70 were randomly assigned to umbilical cord blood (n=186) or hemodynamic complex (n=182) transplants.
these two types of supply, the intensity reduction regulation includes systemic radiotherapy combined with cyclophosphamide and fluorodalabin chemotherapy.
the anti-host disease prevention therapy for transplants after cord blood transplantation is cyclosporine and phosphatidol esters, and the prevention therapy after the combination of polypics is cyclophosphamide, tekmos, and anti-macophenol esters.
end point is a two-year progress-free survival rate.
(Recovery of neutral granulocytes after A. two transplants; B. Recovery of plateplates after transplantation) was randomly grouped, the treatment group had similar ages, genders, self-reported races, manifestations, diseases, and disease status.
2-year progression survival rate after umbilical cord blood and monolithic combined transplantation was 35% (95% CI 28-42%) and 41% (34-48%, p-0.41), respectively.
pre-specified secondary endpoint analysis showed that the non-recurrence mortality rate was 18% (95% CI 13-24%) in the 2 years after umbilical cord blood transplantation, higher than 11% (95% CI 6-16%, p-0.04) after the monolithic combined transplantation.
survival rate of 2 years after cord blood transplantation and hydrome-combined transplantation was 46% (95% CI 38-53) and 57% (49-64%, p-0.04), respectively.
, there was no statistical difference between the main endpoints of the two transplant sources and the two-year non-progression survival rates.
Although both donor sources have expanded the availability of low-intensity transplantation, the analysis of secondary endpoints, including total survival, suggests that the prognostication of bone marrow transplantation of single-multiplied combined donor sources may be better.
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