Clinical analysis of genetic haploidentical peripheral blood stem cell transplantation on relapsed and refractory acute leukemia

Abstract

Objective To observe the clinical efficacy of genetic haploidentical peripheral blood stem cell transplantation on relapsed and refractory acute leukemia. Methods The clinical data of 57 patients with relapsed and refractory acute leukemia who accepted genetic haploidentical peripheral blood stem cell transplantation were retrospectively analyzed, including 43 cases of acute lymphoblastic leukemia (ALL), 14 cases of acute myeloid leukemia (AML). Haploidentical peripheral blood stem cell transplantation using modified BU/CY+ ATG ; applying cyclosporine A+ mycophenolate mofetil+ short-range methotrexate±basiliximab to prevent graft-versus-host disease. Results Fifty-seven patients with relapsed and refractory acute leukemia were followed for an median of 32 months(2-65 months), infection rate of granulocyte lack period was 84.2%(48/57); the incidence of neutrophil reconstruction was 98.2%(56/57), the median implanted time was 14 d(10-22 d), the rate of platelet engraftment was 91.2%(52/57), median implanted time was 20 d(10-90 d); the incidence of GVHD was 61.4%(35/57), including acute GVHD [26.3%(15/57)], the incidence of chronic GVHD was 35.1%(20/57); the incidence of hemorrhagic cystitis was 36.8%(21/57); the recurrence rate after transplantation was 24.6%(14/57), 2 cases got posttransplant lymplaoproliferative disease; the nonrelapse mortality was 31.6%(18/57); 3 years overall survival was 44%, 3 year disease-free survival was 40%. Conclusions In the absence of HLA-identical siblings donors and unrelated donor, genetic haploidentical peripheral blood stem cell transplantation for treatment of relapsed and refractory acute leukemia is an effective and feasible method. Key words: Haploidentical hematopoietic stem cell transplantation; Acute leukemia; Recurrence rate; Disease-free survival