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Number of Infectious Agents Isolated from 1 Patient


Figure 3.11. Number of infectious agents isolated from 1 patient

Comments: Up to 15 patients isolated at least 02 agents.



Note: BN: patient, VK: Bacteria, VN: Fungus, VR: virus


Figure 3.12. Combination of infectious agents isolated from 1 patient Comment: Up to 15/20 patients isolated many groups of combined agents such as bacteria and/or viruses and/or fungi, of which the most common is a combination of viruses and bacteria.



Figure 3.13. Characteristics of bacterial/fungal infectious agents

Comments: The bacterial/fungal pathogens are very diverse, the most common being Staphylococcus (7/20), followed by pathogens such as Clostridium (5/20), Candida (4/20), Stenotrophomonas (4/20), Klebsiella (4/20).


3.2.4.2. Characteristics of graft-versus-host disease after transplantation

Table 3.13. Characteristics of acute graft-versus-host disease in transplant patients



Characteristic


Location


Level


Number of cases


Acute graft-versus-host disease

Digestion + skin

Phase III

02


08


Skin

Phase I

05

Phase II

01

No acute graft-versus-host disease detected

12

Total

20

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Comments: 8/20 patients had acute graft-versus-host disease, mainly mild graft-versus-host disease in the skin (6 cases), and 2 cases of severe graft-versus-host disease in the digestive tract.

Table 3.14. Characteristics of chronic graft-versus-host disease in transplant patients



Characteristic


Location


Level

Number of cases


Have chronic graft-versus-host disease

Skin

Light

05


06

Lungs + skin

Heavy

01

No chronic graft-versus-host disease detected

14

Total

20

Comments: Chronic graft-versus-host disease was found in only 6/20 cases, mainly mild graft-versus-host disease in the skin, with 1 case of combined lung and skin lesions.


Table 3.15. Relationship between acute and chronic graft-versus-host disease


Status

graft

Stage

100 days ago

Stage

after 100 days

Number of cases


Has grafted from MDR


No GvHD level

No chronic GvHD

4

Have chronic GvHD of the skin

2


Has simple cutaneous GvHD

No chronic GvHD

2

Mild chronic cutaneous GvHD

2

Chronic pulmonary GvHD and

skin

1


Has gastrointestinal and skin GvHD

No chronic GvHD

1

Death from GvHD

1

Rejection and second successful transplant

from haplotype source


Has simple cutaneous GvHD


Mild chronic cutaneous GvHD


1

No grafting and death

6

Total

20

Comments: Acute and chronic graft-versus-host disease are only found in cases with graft overgrowth, in which the relationship between these two conditions is not really clear. In some cases, these two conditions coexist in the same patient, but there are cases where acute GvHD appears but chronic GvHD does not appear later and vice versa.


3.3. RELATIONSHIP BETWEEN SOME FACTORS AND THE RESULTS OF COMMUNITY-DONE UNIVERSAL CORD BLOOD STEM CELL TRANSPLANTATION

3.3.1. Correlation between HLA compatibility level and transplant outcome


HLA 5/6 and 6/6 compatibility (n=10) 60.0 ± 15.5%



Log-rank p=0.585

HLA 4/6 compatibility (n=10) 40.0 ± 19.3%


Figure 3.14. Correlation between HLA compatibility level and overall survival probability

Comments: Patients with HLA compatibility of 5/6 loci or more had a 1-year overall survival rate of 60%, higher than the group with 4/6 loci compatibility (40%), however the difference was not statistically significant (p > 0.05).

Table 3.16. Correlation between HLA compatibility level and some transplant outcomes

Result


Element

HLA matching


OR


p*

4/6

5/6 or 6/6

Blood cell recovery

Are not

3

4

0.64

> 0.05

Have

7

6

Acute graft-versus-host disease

Are not

5

7

0.43

> 0.05

Have

5

3

Chronic graft-versus-host disease

Are not

8

6

2.7

> 0.05

Have

2

4

* Yates corrected χ 2 test for small sample size


Comments: Patients with HLA compatibility with cord blood at 4/6 loci or higher had no difference in the rate of blood cell recovery and the possibility of developing graft-versus-host disease (p > 0.05).

3.3.2. Relationship between cell dose and transplantation outcome

Table 3.17. Relationship between cell dose and survival probability after transplantation


Group


Result

Post-transplant mortality

n=9

Survival after transplantation

n=11


p*

Mean CD34 cell dose (10 5 cells/kg)


3.02 ± 2.58


3.13 ± 2.52


> 0.05

Cell dose

medium nuclei (10 7 cells/kg)


4.88 ± 1.37


5.72 ± 3.52


> 0.05

*T-test

Comment: The mean nucleated cell dose and CD34 cell dose in the group of patients who died after transplantation did not have statistically significant differences.

Table 3.18. Relationship between cell dose and blood cell recovery ability

Result


Group

Mean CD34 cell dose (10 5 cells/kg)

Cell dose

medium nuclei (10 7 cells/kg)


Blood cell recovery

There is recovery n=13

3.72 ± 2.89

5.77 ± 3.23

Are not

n=7 recovery


1.9 ± 0.45


4.56 ± 1.30

p*

< 0.05

> 0.05

*T-test

Comments: The mean CD34 cell dose of the group of patients with hematologic recovery was statistically significantly higher than that of the group without recovery (p < 0.05), while the mean nucleated cell dose between the two groups was not statistically significantly different.


3.3.3. Relationship between pre-transplant remission status and transplant outcome


First remission before transplantation (n=14) 64.3 ± 12.8%

Second remission or 25.0 ± 20.4%

Log-rank p=0.391

3 (n=6)


Figure 3.15. Correlation between pre-transplant remission status and overall survival probability

Comments: Cases with first remission and immediate transplantation had a higher probability of overall survival than cases with second or third remission, however the difference was not statistically significant.

Table 3.19. Correlation between pre-transplant remission status and blood cell recovery rate

Result


Element

Blood cell recovery


OR


p*

Are not

Have


Pre-transplant remission level

From the 2nd time

3

3


2.5


> 0.05

First time

4

10

* Yates corrected χ 2 test for small sample size

Comments: The rate of blood cell recovery in cases of first remission and immediate transplantation was 2.5 times higher than in cases of second or third remission, however the difference was not statistically significant.


3.3.4. Relationship between mutation status and transplantation outcome


No mutations detected (n=13) 63.5 ± 15.3%

Mutations (n=7) 28.6 ± 17.1%

Log-rank p=0.012

Figure 3.16. Correlation between disease gene mutation status and overall survival probability

Comments: Patients without specific mutations detected had a statistically significant higher overall survival probability than the group with specific mutations (63.5% vs 28.6%, p<0.05).

Table 3.20. Correlation between disease gene mutation status and blood cell recovery rate

Result


Element

Blood cell recovery


OR


p*

Are not

Have


Detect specific mutations

Are not

3

10


0.225


> 0.05

Have

4

3

* Yates corrected χ 2 test for small sample size

Comments: Patients with specific mutations tended to have lower rates of blood cell recovery than those without detected specific mutations, but the difference was not statistically significant.

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