Analysis on single-center clinical effect of allogeneic hematopoietic stem cell transplantation for treatment of acute myeloid leukemia / 重庆医学

ABSTRACT

Objective To summarize and analyze the clinical effect of allogeneic hematopoietic stem cell transplantation(alloHSCT) for treating acute myeloid leukemia(AML) in this center.Methods The clinical data of 87 patients with AML receiving allo-HSCT in this hospital from January 2008 to June 2015 were retrospectively analyzed on the overall survival rate(OS) after transplantation,leukemia-free survival rate (LFS) and relapse rate (RR),transplant-related mortality (TRM),moreover the efficacies of HLA-matched (kinship and unrelated) and haploidentical transplantation were compared.Meanwhile the influence of different transplantation of pre-leukemia remission status on transplantation curative effect was analyzed.Results Among 87 cases,OS after 2 years was (73.6±4.7)％ and 2-year LFS was (62.1±5.8)％.During the follow-up period,27 cases (31.3％) relapsed and 23 cases (26.4％) died.The 2-year OS in HLA-matched (kinship and unrelated) and haploidentical transplantation were (76.3± 5.3)％ and (68.5±7.2)％ respectively(P＜0.05) and the 2-year LFS were (60.2±4.8)％ and (56.3±5.7)％ respectively (P＜ 0.05).The incidence rate of aGVHD and infection in haploidentical transplantation group was significantly higher than that in the HLA matched group (kinship and unrelated),but their RR were 26.9 ％ and 29.2 ％ respectively (P＞0.05).The transplantation effect analysis in different leukemia remission state showed that RR in the unreaching CR before transplantation group,reaching CR but minimal residual(MRD) positive group and negative group were 68.7 ％,34.7 ％ and 16.6 ％ respectively.The 2-year LFS were (18.7±5.2)％,(56.5± 6.3)％ and (79.2％ ±5.7)％ respectively (P＜0.05).The 2-year OS were (31.2± 5.3)％,(69.6± 7.2) ％ and (89.6±5.3)％ respectively (P＜0.05).Conclusion allo-HSCT is an effective method for treating AML.Recurrence is the main cause of failure after transplantation therapy.