Efficacy analysis of unrelated cord blood transplantation in the treatment of refractory and relapsed adult acute leukemia.
10.3760/cma.j.issn.0253-2727.2018.02.006
- Author:
Xian Deng CHU
1
;
Er Ling CHEN
;
Xiao Yu ZHU
;
Bao Lin TANG
;
Chang Cheng ZHENG
;
Kai Di SONG
;
Xu Han ZHANG
;
Juan TONG
;
Xiang WAN
;
Lei ZHANG
;
Hui Lan LIU
;
Zi Min SUN
Author Information
1. Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China.
- Publication Type:Journal Article
- Keywords:
Drug resistance, neoplasm;
Hematopoietic stem cell transplantation;
Leukemia, acute;
Relapse;
Survival
- MeSH:
Acute Disease;
Adolescent;
Adult;
Cord Blood Stem Cell Transplantation;
Female;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation;
Humans;
Leukemia/therapy*;
Male;
Peripheral Blood Stem Cell Transplantation;
Retrospective Studies;
Transplantation Conditioning;
Young Adult
- From:
Chinese Journal of Hematology
2018;39(2):105-109
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the clinical efficacy and safety of unrelated umbilical cord blood transplantation (UCBT) in the treatment of refractory and relapsed acute leukemia (AL) patients. Methods: The clinical data of 22 refractory and relapsed AL patients who were treated with UCBT as salvage therapy from November 2009 to May 2017 were retrospectively analyzed. All patients received a myeloablative conditioning regimen for prevention of graft-versus-host disease (GVHD) with cyclosporine A (CSA)/short course of mycophenolate mofetil (MMF). Results: ①Of 22 patients, 9 cases were male and 13 female. The median age was 23 (15-44) years and median weight of 52.5 (43-82) kg. All patients were transplanted with a median umbilical cord blood nucleated cells of 3.07 (1.71-5.30)×107/kg (by weight), the median CD34+ cells was 1.60 (0.63-3.04)×105/kg (by weight). ②The myeloid cumulative implantation rate was 95.5% (95%CI 45.2-99.7%) after transplantation of 42 d, with the median implantation time of 19 (13-27) d. The platelet cumulative implantation rate after transplantation of 120 d was 81.8% (95%CI 54.2-93.6%), the median implantation time of 42 (20-164) d. ③The incidence of Ⅱ-Ⅳ, Ⅲ-Ⅳ aGVHD and the 2 year cumulative incidence of cGVHD were 36.4%, 13.6% and 40.3% respectively. ④ The transplant related mortality (TRM) after transplantation of 180d was 22.7%, 2 year cumulative rate of relapse was 18.7% (95%CI 3.6-42.5%), 2 year disease-free survival rate (DFS) and overall survival rate (OS) were 53.7% and 58.1%, respectively. Conclusion: The preliminary results show that the use of UCBT is safe and effective for refractory and relapsed AL patients who fail to respond to conventional chemotherapy.
