Evaluation of the Efficacy and Safety of Treatment on Using Single-Unit Unrelated Umbilical Cord Blood Transplantation Based on Umbilical Cord Blood Provided By China's Public Cord Blood Bank

Objective It mainly analyzes the umbilical cord blood used in umbilical cord blood transplantation (UCBT), which is provided by China's public cord blood bank. It made an analysis for the effect and safety of malignant hematologic diseases cured by UCBT. Methods We retrospectively analyzed 353 cases of patients with malignant hematologic diseases who accepted myeloablative single-unit unrelated donor UCBT without ATG at our center between Jan 2009 and December 2016. It made a comparative analysis for the umbilical cord blood's TNC before freezing and after thawing, the cells of CD34⁺, the recovery rate of cells and the clinical effect of UCBT. Results 353 units of umbilical cord blood used in UCBT respectively came from eight China's public cord blood banks. The average of 353 units of umbilical cord blood's TNC before freezing、after the tubular recovery、transfusion were respectively 18.4×10⁸、16.27×10⁸、15.75×10⁸ , the number of TNC was significantly reduced after the recovery of the tubule and transfusion(P=0.000),and there was no difference for the tubular recovery and transfusion(P=0.132) . The average of CD34+ cells before freezing and after the tubular recovery were 11.16×10⁶, 8.68×10⁶ (P=0.000). The average recovery rate of the tubular recovery 、 umbilical cord blood transfusion and CD34+ cells after the tubular recovery was respectively 88.5%、86.5%、80.3%, the difference of recovery rate in each bank was obvious statistically significant (P=0.000,P=0.000,P=0.000). When 353 patients made the UCBT, the cumulative incidence of neutrophil 、platelet、erythrocyte engraftment was respectively 95.8%、84.9%、89.0%, it had the engraftment median time was respectively 17d (11d-42d)、38d (14d-120d)、23d (9d-60d). After CB provided by each bank was used in UCBT, it got the difference about cumulative incidence of engraftment (P=0.025,P=0.0045,P=0.00072). During 100 days after UCBT, the cumulative incidence about the Ⅱ-Ⅳ degrees of acute graft-versus-host disease (aGVHD) were 46.5%. After CB provided by each bank was used in UCBT, it got the no difference about cumulative incidence of aGVHD (P=0.904). During 3 years after UCBT, the cumulative incidence of relapse was 17.85%. After CB provided by each bank was used in UCBT, the difference about cumulative incidence of relapse was no statistical significance (P=0.654). During 3 years after UCBT, the overall survival (OS) rate、disease free survival (DFS) rate and the rate of graft-versus-host diseases/relapse-free survival (GRFS) were respectively71.1 %、66%、59.7%. After CB provided by each bank was used in UCBT, the difference about the rate of OS、DFS、GRFS were no statistical significance(P=0.689,P=0.719,P=0.477). Conclusion The umbilical cord blood provided by China's public cord blood bank was used in UCBT. It has a high safety and good efficacy in treating malignant hematologic diseases. But it needs to set up the standardized and normalized quality-control system of umbilical cord blood for China's public cord blood bank.