Objective@#To analyze the
efficacy of HLA-haploidentical peripheral
hematopoietic stem cell transplantation (haplo-PBSCT) following reduced intensity conditioning (RIC) regimen to treat the
patients with
hematological malignancies who were older than 50 years old.@*
Methods @#Eighteen
patients with
hematological malignancies over 50 years were enrolled, including 8
male and 10
female patients . The median age of all
patients was 52 (range 50–66) years. Of them, 8
patients had
acute myeloid leukemia (AML) , 2
chronic myelocytic leukemia (CML) , 5
myelodysplastic syndrome (MDS) , 2
acute lymphoblastic leukemia (ALL) , and 1
aggressive natural killer cell leukemia (ANKL) . All
patients received fludarabine,
cytarabine and
melphalan with
rabbit anti-
human thymocyte globulin (FAB+rATG regimen) and transplanted with high
dose non-
T cell -depleted peripheral
hematopoietic stem cells from
donors . Enhanced
graft versus host disease (GVHD) prophylaxis and
infection prevention were administered.@*Results@#Fifteen days after
transplantation , 16
patients achieved complete
donor chimerism . One of them rejected the
donor graft completely at thirty days after
transplantation , and the other 2
patients had mixed
chimerism 15 days after
transplantation and converted to complete recipient
chimerism at 30 days after
transplantation . The
cumulative incidence of acute GVHD (aGVHD) was 61.1% (95%CI49.6%-72.6%) . The
incidence of grade Ⅱ-Ⅳ aGVHD was 35.4% (95%CI 21.1%-49.7%) , whereas grade III-IV was 13.8% (95%CI 4.7%-22.9%) . The 2-year
cumulative incidence of chronic GVHD (cGVHD) rate was estimated at 38.2% (95%CI 25.5%-50.9%) .
Patients were followed-up for a median of 14.5 months (range, 3-44 months) . The Kaplan Meier estimates of 2-year overall
survival (OS) and
disease-free survival (DFS) was 72.6% (95%CI 60.1%-85.1%) and 63.7% (95%CI 49.2%-78.2%) , respectively. The 2-year
cumulative incidence of
relapse and non-
relapse -
mortality (NRM) was 31.2% (95%CI 16.5%-45.9%) and 12.5% (95%CI 4.2%-20.8%) , respectively.@*Conclusion@#RIC-haplo-PBSCT protocol can achieve better results in
patients with
hematologic malignancies over 50 years old.