[Efficacy analysis of haploidentical allogeneic hematopoietic stem cell transplantation in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia]

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2014 Dec;22(6):1678-83. doi: 10.7534/j.issn.1009-2137.2014.06.033.
[Article in Chinese]

Abstract

This study was aimed to explore the effect and feasibility of related haploidentical allogeneic hematopoietic stem cell transplantation (hi-HSCT) used in the treatment of patients with Ph⁺ ALL. A total of 22 patients with Ph⁺ ALL received related hi-HSCT from March 2008 to August 2013. The clinical data of all cases were retrospectively analyzed.There were 15 cases of CR1, 3 cases of CR2, 1 case of CR3 and 3 cases of relapse. The bone marrow and peripheral blood stem cells of related haplotype donors were used for transplantation. All patients were subjected to pretreatment consisting of cytarabine, busulfan (Bu), cyclophosphamide and tota1 body irradiation (TBI), etc. GVHD was prevented by combining variety of immunosuppressants including CsA, MTX, MMF and ATG, etc. The results showed that all of 22 patients acquired hematopoietic reconstitution, and the median time of granulocytes exceeding 0.5 × 10⁹/L and platelets exceeding 20 × 10⁹/L which were transplanted by donors were 13 days and 23 days respectively. The mean follow-up period was 13 months. Ten patients had experience of aGVHD, and 8 patients had experience of cGVHD. Two patients died of infection, 3 died of GVHD and 3 died of relapse,and the rest patients were alive in disease-free situation at lase follow-up. The 2-year disease-free surviva1 rate was 57%. It is concluded that related hi-HSCT can prolong disease-free survival of Ph(+)ALL patients and even cure.

MeSH terms

  • Allografts
  • Cyclophosphamide
  • Disease-Free Survival
  • Graft vs Host Disease
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunosuppressive Agents
  • Neoplasm Recurrence, Local
  • Philadelphia Chromosome
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Retrospective Studies
  • Tissue Donors

Substances

  • Immunosuppressive Agents
  • Cyclophosphamide