Allogeneic hematopoietic stem cell transplantation for 76 patients with leukemia / 中国实用内科杂志

ABSTRACT

Objective To observe the efficacy and main complications of allogeneic hematopoietic stem cell transplantation(allo-HSCT)for 76 patients with hematopoietic malignancies.Methods From September 2001 to March 2007,76 patients received allo-HSCT in Department of Hematology,Xijing Hospital,Fourth Military Medical University.All cases included 24 acute myeloid leukemia(AML),15 acute lymphocytic leukemia(ALL)and 34 chronic myelogenous leukemia(CML)and 3 T cell lymphoma/leukemia.Donors were HLA-identical sibling(n=57),1 locus mismatched sibling(n=3),HLA-matched unrelated volunteer(n=9)and haplo-identical sibling(n=7).Conditioning regimen consisted of busulphan-cyclophosphamide or cyclophosphamide and total body irradiation plus Ara-c/VP-16.Graft versus-host disease prophylaxis was the standard methotrexate and cyclosporine combination.Anti-human thymocyte immunoglobulin(ATG)and CD25 monoclonal antibody was given in unrelated donor and haplo-identical HSCT.Results Totally 73 patients got sustained engraftment.Acute GVHD and chronic GVHD were found in 18/73(24.7%)and 24/73(32.9%)patients,respectively.Severe veno-occlusive disease occurred in 2 cases.Pure red cell aplasia was found in 5 patients with major ABO mismatched HSCT.With a follow-up of 3 to 76 months,43/76(56.6%))patients were still alive and 33/76(43.4%)died from leukemia relapse or transplantation-related complications.Conclusion Allogeneic heamatopoietic stem cell transplantation is an effective therapy for leukemia,especially in CML-chronic period and acute leukemia in complete remission,but there is high rate of relapse in patients with high-risk and refractory status before transplantation.