Clinical study on treatment of high-risk acute leukemia with unrelated cord blood transplantation / 器官移植

ABSTRACT

Objective To investigate the effect of unrelated cord blood transplantation (UCBT)on the treatment of high-risk childhood and adult acute leukemia.Methods Ten patients with high-risk acute leukemia underwent UCBT.Among the 1 0 patients,3 were children and 7 were adults with the median age of 29 years old (1 1 -41 years old).Six patients underwent one-unit cord blood transplantation and four patients underwent two-unit cord blood transplantation.The myeloablative conditioning regimen without antithymocyte globulin (ATG)was adopted.Cytarabine (Ara-C),fludarabine (Flu)or total body irradiation (TBI)was added on the basis of busulfan (Bu)and cyclophosphamide (Cy).Ciclosporin and mycophenolate mofetil were used to prevent graft-versus-host disease (GVHD).Results The transplantation was successful in 8 (80%) patients.The median implant-time of leukocytes was 1 9 d(1 4-25 d)and that of platelets was 40 d(33-60 d).Three patients developed acute GVHD and no patient developed chronic GVHD.The median follow-up time was 24 months (1 -29 months).Seven patients remained in disease-free survival.Both the 2-year overall survival and disease-free survival rates were 66.7%.Conclusions UCBT is feasible in the treatment of high-risk acute leukemia.UCBT is the preferred option for the high-risk patients without HLA-identical sibling donors,which is characterized by low incidence of GVHD and low recurrence rate.It may make patients with acute leukemia remain long-term survival.