Clinical research of reduced intensity allogeneic hematopoietic stem cell transplantation for relapsed or refractory lymphoma

Abstract

Objective To explore the efficacy and safety of reduced intensity allogeneic stem cell transplantation(allo-HSCT)in the treatment of relapsed or refractory lymphoma. Methods 5 patients with relapsed or refractory lymphoma received reduced intensity allo-HSCT from January 2012 to December 2013 of Beijing Military General Hospital, including 4 males and 1 female, aged from 20 to 39 years old, with the mean age 28.7 years old. 3 cases were HLA-identical matching and the other two cases were HLA-haploidentical. Donors received granulocyte colony-stimulating factor mobilization, and stem cells were collected from both peripheral blood and bone marrow. Pretreatment scheme reduced the strength of pretreatment for fludarabine combined with busulfex and ATG. Combined immunosuppressive agents were used for graft-versus-host disease(GVHD)prophylaxis, including cyclosporine A, methotrexate, mycophenolate mofetil and soon. The toxicity, GVHD and disease-free survival in patients were observed after transplantation. Results All of the patients acquired hematopoietic reconstitution. The average time of the neutrophils count ≥ 0.5 × 109/L and platelets ≥ 20×109/L were 18.8 d and 24.5 d, respectively. Implantation was confirmed by the evidence of 100 % of donor hematopoiesis. As of follow-up to December 2014 with the median 19.2 months(6-35 months), 2 cases died of recurrence, the other 3 patients remained disease-free survival, and the longest disease-free survival time was up to 35 months. Conclusions Reduced intensity allogeneic hematopoietic stem cell transplantation is an effective and safe method for relapsed or refractory lymphoma, which could be chosen as a salvage treatment method for relapsed or refractory lymphoma. Key words: Allogeneic hematopoietic stem cell transplantation; Rducing strength; Rlapsed; Refractory; Lymphoma