Blood glucose recovery following allogenetic hematopoietic stem cell transplantation in patients with hematological diseases complicated with diabetes mellitus / 中国组织工程研究

BACKGROUND:Recent studies have shown that the large-dose regular insulin therapy used to control blood glucose levels can cause 50%of patients suffering from vascular, optic nerve and kidney complications. Previous results from authors exhibit that when al ogeneic hematopoietic stem celltransplantation is applied for treatment of leukemia, diabetic symptoms in patients disappear. Dose it prompt that al ogeneic hematopoietic stem celltransplantation is an effective therapy for treatment of diabetes mel itus? OBJECTIVE:To explore the feasibility of hematopoietic stem celltransplantation for treatment of diabetes mel itus. METHODS:A retrospective analysis was done regarding the data of patients with hematological diseases complicated with diabetes mel itus who underwent al ogenetic hematopoietic stem celltransplantation. Four patients with acute lymphocyte leukemia, chronic myelogenous leukemia, aplastic anemia, and myolodysplastic syndromes, respectively, were complicated with diabetes mel itus. Conditioning regimen was cyclophosphamide+total body irradiation protocol. Cyclosporin A and short-term methotrexate were used for graft-versus-host disease prophylaxis. Blood glucose was control ed by oral hypoglycemic drugs or insulin injections before transplantation. RESULTS AND CONCLUSION:Al the four patients were successful y engrafted. Fasting glucose level of the four patients recovered at 4-6 months after hematopoietic stem celltransplantation (without hypoglycemic drugs). One patient died of leukemia relapse after 12 months of hematopoietic stem celltransplantation. The other three patients had disease-free survival until the time of fol ow-up.

Second allogeneic hematopoietic stem cell transplant from one sibling donor for a patient with acute myeloid leukemia relapsed after the first transplantation / 白血病·淋巴瘤

Objective To evaluate the efficacy of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treatment of leukemia relapsed after first allo-HSCT from one sibling donor.Methods One patient with acute myeloid leukemia (AML-M4) underwent sibling donor bone marrow transplant (conditioning regimens was Bu/Cy) and relapsed after 18 months. The patient received the same donor's peripheral blood stem cell (PBSC) for second transplantation after receiving CY-TBI regimens,and reduced intension of prophylaxis of GVHD. Results The patient achieved stable engraftment after second HSCT. The patients suffered acute GVHD (intestinal Ⅳ and cutaneous Ⅲ) and had been complete remission to +8 months. Conclusion Second related HSCT is feasible in relapsed patient who had undergone related allo-BMT.