Parental haploidentical hematopoietic stem cell transplantation for hematologic diseases: A report of 45 cases / 解放军医学杂志

ABSTRACT

Objective The present report describes the clinical effects of parental haploidentical hematopoietic stem cell transplantation (hi-allo-HSCT) in the treatment of hematologic diseases. Methods A total of 45 patients received parental hiallo- HSCT from July 2007 to January 2011. The therapeutic effects and complications were observed. Results Engraftment was successful in a total of 43 patients. Implantation failed in 2 patients. The incidence of the graft versus host disease (GVHD) was 62.2%. The incidence of acute GVHD was 40.0%, and chronic GVHD occurred in 22.2% of the patients. The incidence of GVHD was lower when the father was the donor compared with the mother was the donor. The incidence of GVHD was related to the age of the donor and the number of HLA matching sites. In addition, infections observed in the present study were mainly blood-borne with cytomegalovirus as the invader and lung infections. During the follow-up period of 6 months to 4 years, six patients died in the 43 patients with successful implantation. The major cause of death was infection and a relapse of their original disease. The disease free survival (DFS) rate was 86.7%. Seven patients additionally received umbilical cord blood, their efficacy in the transplantation seemed better than those who received parental stem cells only, as hematopoietic reconstruction was faster and the incidence of GVHD accounted for only 7.14% of the total incidence rate. Conclusions Parental hi-allo-HSCT is an effective treatment for hematologic diseases. A young male donor with more HLA matching sites is recommended to prevent GVHD and infection. The combination of parental hi-allo-HSCT and umbilical cord blood transplantation could result in positive effects with faster hematopoietic reconstruction and a lower incidence of GVHD.