Allogeneic peripheral blood stem cell transplantation for 75 cases of hematologic malignancies.
- Author:
Han-Xin WU
1
;
Si-Xuan QIAN
;
Min HONG
;
Ya-Ping ZHANG
;
Hua LU
;
Run ZHANG
;
Xiao-Yan ZHANG
;
Li-Juan CHEN
;
Rui-Nan LU
;
Su-Jiang ZHANG
;
Peng LIU
;
Zheng GE
;
Lei FAN
;
Li WANG
;
Ji XU
;
Tian TIAN
;
Yu ZHU
;
Hong-Xia QIU
;
Wei XU
;
Rui-Lan SHENG
;
Jian-Yong LI
Author Information
1. Department of Hematology, The First Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Aged;
Female;
Hematologic Neoplasms;
surgery;
Hematopoietic Stem Cell Transplantation;
methods;
Humans;
Leukemia, Myeloid;
surgery;
Male;
Middle Aged;
Peripheral Blood Stem Cell Transplantation;
methods;
Retrospective Studies;
Transplantation Conditioning;
Transplantation, Homologous;
Young Adult
- From:
Journal of Experimental Hematology
2008;16(6):1330-1333
- CountryChina
- Language:Chinese
-
Abstract:
The aim of this study was to explore the clinical effect and complications of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) in hematologic malignancies through retrospective analysis of 75 patients (42 male, 33 female; aged from 13 to 72 years old) received allo-PBSCT from HLA matched (n=61) or haploidentical donors (n=14). 75 patients included 35 patients with chronic myeloid leukemia (CML), 30 patients with acute myeloid leukemia, 5 patients with severe aplastic anemia, 3 patients with acute lymphocytic leukemia, one patients with multiple myeloma and one patients with paroxysmal nocturnal hemoglobinuria. Conditioning regimens were (1) Cy/TBI or Bu/Cy; (2) Cy/TBI+Ara-C; (3) fludarabine+TBI/or (CTX+ATG). Minimal residual disease has been monitored regularly by PCR and FISH. Patients received cyclosporine A and methotrexate or ATG and anti-CD25 monoclonal antibody and mycophenolate mofetil for graft-versus-host disease (GVHD) prophylaxis. Relapsing patients after transplantation received DLI and/or chemotherapy. Patient with CML were treated with imatinib. The results showed that 74 patients had hematopoietic reconstitution, and eventually converted to full donor chimerism by FISH or PCR-STR. The median time for the initial hematopoietic reconstitution was 15 (5-25) days. 46 out of 75 patients were alive and median duration was 23 (2-61) months. Among 29 dead patients, 9 died of disease relapse, 7 died of III-IV grade of acute GVHD and 7 died of severe infection (2 patients developed interstitial pneumonia). 9 out of 14 patients received haploidentical transplantation were alive, and the time of event-free survival was 30 (6-53) months, the mean survival time of 5 died patients was 7 (2-17) months. 16 patients were infected by cytomegalovirus, 2 of them died of interstitial pneumonia. None of them suffered from veno-occlusive disease in the liver. It is concluded that allo-PBSCT is effective to treat refractory hematologic diseases, and DLI/or chemotherapy should be used in the patients relapsing after transplantation.
