Transplant Outcomes in Beta-Thalassemia Major Patients Receiving Combined Granulocyte Colony-Stimulating Factor-Primed Bone Marrow and Cord Blood Graft Compared to Granulocyte Colony-Stimulating Factor-Primed Bone Marrow Alone

<b><i>Background:</i></b> Hematopoietic stem cell transplantation (HSCT) is currently the only curative treatment for thalassemia major^TM. Graft rejection (GR) and graft-versus-host disease (GVHD) are the primary obstacles to a successful outcome. <b><i>Methods:</i></b> We conducted a retrospective study of HSCT in 29 children (median age at transplantation: 6 years) with Beta-thalassemia (β-TM) after the combined infusion of granulocyte colony-stimulating factor-primed bone marrow (G-BM) and cord blood (CB) from the human leukocyte antigen (HLA)-identical sibling donors. We also compared the outcomes of the co-transplanted children with those of children with β-TM who received G-BM alone from an HLA-identical sibling donor (<i>n</i> = 26). <b><i>Results:</i></b> Compared to the G-BM transplant (G-BMT) recipients, those who received a co-transplant had a lower incidence of grade ≥II acute (17.24 vs. 30.7%, <i>p</i> = 0.047) and limited chronic (0 vs.15.4%, <i>p</i> = 0.022) GVHD as well as a lower incidence of GR (0 vs. 7.7%, <i>p</i> = 0.132). Neutrophil recovery time was faster in the co-transplant group (18.5 vs. 21 days, <i>p</i> = 0.04). All the patients were monitored until December 31, 2016; the median follow-up time was 74 months<unterline>,</unterline> and the 5-year thalassemia-free survival rate was 89.7% in the co-transplant group and 84.6% in the G-BMT-alone group (<i>p</i> = 0.590). <b><i>Conclusions:</i></b> A combined CB and G-BM graft from an HLA-identical sibling donor is an effective treatment option for TM in children, with less acute and chronic GVHD.