Efficacy observation of high-dose non-T-cell depleted PBSC used as grafts for haploidentical HSCT with reduced intensity conditioning in elderly patients with AML/MDS
10.3760/cma.j.cn115356-20221227-00362
- VernacularTitle:高剂量非体外去T细胞PBSC作为移植物行减低剂量预处理单倍体HSCT治疗老年急性髓系白血病及骨髓增生异常综合征患者效果观察
- Author:
Wenyan MIAO
1
;
Jianli XU
;
Hailong YUAN
;
Hongbo WANG
;
Ying LIU
;
Chunxia HAN
;
Linglu DING
;
Ming JIANG
Author Information
1. 新疆医科大学第一附属医院血液病中心 新疆维吾尔自治区血液病研究所，乌鲁木齐 830054
- Keywords:
Leukemia, myeloid, acute;
Myelodysplastic syndromes;
Hematopoietic stem cell transplantation;
Peripheral blood stem cells;
Aged
- From:
Journal of Leukemia & Lymphoma
2023;32(11):652-657
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of high-dose non-T-cell depleted peripheral blood stem cells (PBSC) used as grafts in haploidentical hematopoietic stem cell transplantation with reduced intensity conditioning (RIC-haplo-HSCT) in the treatment of elderly patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS).Methods:The clinical data of AML or MDS 28 patients aged ≥50 years who underwent RIC-haplo-HSCT in the First Affiliated Hospital of Xinjiang Medical University from January 2014 to June 2022 were retrospectively analyzed. All patients received high-dose non-T-cell depleted PBSC as grafts. Anti-CD25 monoclonal antibody and glucocorticoid were added as intensive graft-versus-host disease (GVHD) prophylaxis.Results:All patients achieved hematopoietic reconstruction. The accumulative incidence of grade Ⅱ-Ⅳ and Ⅲ-Ⅳ acute GVHD within 100 d was 22.5% (95% CI 5.1%-39.9%) and 8.2% (95% CI 0-19.2%), respectively. The 3-year cumulative incidence of chronic GVHD was 26.8% (95% CI 7.8%-45.8%), and the incidence of extensive chronic GVHD was 5.9% (95% CI 0-17.1%). The median follow-up time was 35.5 (2-83) months. The 3-year cumulative incidence of relapse and non-relapse mortality was 16.7% (95% CI 2.0%-31.9%) and 12.2% (95% CI 0-25.2%), respectively. The 3-year disease-free survival and overall survival rates were 73.3% (95% CI 56.2%-90.4%) and 79.1% (95% CI 62.2%-96.0%), respectively. Conclusions:High-dose non-T-cell depleted PBSC used as grafts for RIC-haplo-HSCT can achieve good clinical efficacy in elderly patients with AML/MDS.
