Umbilical cord blood transplantation and unmanipulated haploidentical hematopoietic SCT for pediatric hematologic malignances.

This study aimed to compare the therapeutic effects of single umbilical cord blood transplantation (UCBT) and unmanipulated haploidentical hematopoietic SCT (haplo-HSCT) in childhood hematologic malignances. We enrolled 410 consecutive children who received either single UCBT (n=37) or haplo-HSCT from a family donor (n=373) during the same time period. For each UCBT recipient, three recipients matched for year of HSCT, underlying diseases, disease status and the length of follow-up were randomly selected from the haplo-HSCT cohort. Hematopoietic recovery was significantly faster in haplo-HSCT recipients than in UCBT recipients. The incidence of chronic GVHD was significantly higher in haplo-HSCT recipients. The incidence of CMV-related interstitial pneumonia was higher in UCBT recipients. The haplo-HSCT recipients had better 1-year OS (73.0% vs 56.8%, P=0.048), lower 1-year non-relapse mortality (NRM, 18.0% vs 35.1%, P=0.026) and lower 2-year NRM rates (19.9% vs 35.1%, P=0.044). The relapse- and disease-free survival rates did not differ significantly between the groups. Our results showed that compared with UCBT, unmanipulated haplo-HSCT can improve the outcomes of children with hematologic malignances.