OBJECTIVE@#To analyze the
efficacy of allogeneic
hematopoietic stem cell transplantation (allo-HSCT) for
treatment of acute
leukemia in the tropical area.@*
METHODS@#Twelve acute
leukemia patients who were underwent allo-HSCT from April 2013 to November 2018 in Hainan
Hospital of
Chinese PLA
General Hospital were selected, including 5 cases of
acute lymphoblastic leukemia (ALL) and 7 case of
acute myeloid leukemia (AML). Three cases received HLA matched
sibling hematopoietic stem cell transplantation, 8 cases received haploidentical
hematopoietic stem cell transplantation, 1 cases received partially mismatched unrelated
hematopoietic stem cell transplantation. Pretreatment regimen 9 cases received modified BU/CY+ATG pretreatment regimen, 3 cases received BU/CY pretreatment regimen.
Graft-versus-host disease (GVHD) prevention regimen all
patients received
cyclosporine A,
mycophenolate mofetil combined with short-term
methotrexate regimen. The
clinical efficacy of allo-HSCT in
treatment of acute
leukemia in the tropical area was analyzed by detecting hematopoietic reconstitution, GVHD,
infection,
relapse and
survival after
transplantation.@*RESULTS@#All the 12
patients achieved
granulocyte reconstruction and
megakaryocyte reconstruction. The median
time of
granulocyte reconstruction was 11.5 (6-14) days, and the median
time of megakaryocytic reconstruction was 12.5 (10-22) days. Within 100 days after
transplantation, the acute GVHD occurved in 8 cases, including 6 cases of Ⅱ-Ⅳ degree acute GVHD and 2 cases of Ⅲ-Ⅳ degree acute GVHD, 11 cases survived more than 100 days after
transplantation, and the chronic GVHD occurred in 1 case, which was mildly limited. Pulmonary
infection occurred in 7 cases, cytomegaloviremia occurred in 6 cases, EB
viremia occurred in 6 cases, and
hemorrhagic cystitis occurred in 5 cases. 2 cases relapsed and eventually died, and the remaining 10
patients survived without
disease until the date of follow-up. The median follow-up
time was 4 (1-68) months, 83.3% (10/12) survived without
disease, and 16.7% (2/12) relapsed.@*CONCLUSION@#Allo-HSCT is an effective
method for the
treatment of acute
leukemia in
adults.
Leukemia patients should be transplanted as soon as possible after remission. The
incidence of
pulmonary fungal infection in transplanted
patients in
tropics is high, therefore the prevention and
treatment of
fungal infection should be strengthened.