Graft failure (GF) is a life-threatening complication after allogeneic stem cell transplantation (SCT). Although salvage SCTs can be performed with haploidentical donor (HID) or cord blood (CB), no study has compared the performances of these two sources. Using nationwide registration data, we compared the transplant outcomes of patients who developed GF and underwent salvage transplantation from HID (n = 129) and CB (n = 570) from 2007 to 2016. The HID group demonstrated better neutrophil recovery (79.7 vs. 52.5% at 30 days, P < 0.001). With a median follow-up of 3 years, both groups demonstrated similar overall survival (OS) and nonrelapse mortality (NRM; 1-year OS, 33.1 vs. 34.6% and 1-year NRM, 45.1 vs. 49.8% for the HID and CB groups). After adjustments for other covariates, OS did not differ in both groups. However, HID was associated with a lower NRM (hazard ratio, 0.71; P = 0.038) than CB. The incidence of acute graft-versus-host disease (GVHD)-related deaths was significantly higher in the HID group, although infection-related deaths were observed more frequently in the CB group. HID may be a promising salvage SCT option after GF due to its faster engraftment and low NRM.

移植失败（GF）是异基因干细胞移植（SCT）后危及生命的并发症。尽管可以使用半相合供体 (HID) 或脐带血 (CB) 进行抢救 SCT，但没有研究比较这两种来源的性能。 使用全国注册数据，我们比较了2007 年至 2016 年发生 GF 并接受 HID（ n  = 129）和 CB（n = 570）挽救性移植的患者的移植结果。HID 组表现出更好的中性粒细胞恢复（79.7 vs. 52.5 30 天时的百分比，P < 0.001)。中位随访 3 年，两组的总生存期 (OS) 和非复发死亡率相似（NRM；1 年 OS，33.1 对 34.6% 和 1 年 NRM，45.1 对 49.8%，HID 和CB 组）。在对其他协变量进行调整后，两组的 OS 没有差异。然而，与 CB 相比，HID 与较低的 NRM（风险比，0.71；P  = 0.038）相关。HID 组与急性移植物抗宿主病 (GVHD) 相关的死亡发生率明显较高，尽管在 CB 组中观察到与感染相关的死亡更为频繁。由于其更快的植入和低 NRM，HID 可能是 GF 后有希望的抢救 SCT 选择。