Efficacy analysis of unrelated cord blood transplantation for 58 acute myelogenous leukemia patients.
- Author:
Liyu WANG
1
;
Huilan LIU
1
;
Liangquan GENG
1
;
Baolin TANG
1
;
Changcheng ZHENG
1
;
Xingbing WANG
1
;
Kaiyang DING
1
;
Guangyu SUN
1
;
Zimin SUN
1
Author Information
- Publication Type:Journal Article
- MeSH: Acute Disease; Adolescent; Cyclosporine; Disease-Free Survival; Fetal Blood; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Incidence; Leukemia, Myeloid, Acute; Mycophenolic Acid; analogs & derivatives; Quality of Life; Recurrence; Remission Induction; Retrospective Studies
- From: Chinese Journal of Hematology 2015;36(8):637-641
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the therapeutic efficacy and related risk factors of acute myelogenous leukemia (AML) patients treated with unrelated cord blood transplantation (UCBT).
METHODSA retrospective analysis was performed on the clinical data of 58 AML patients that consisted of 1 case of M0, 1 case M1, 35 cases M2, 3 cases M4, 14 cases M5, 3 cases M6, and 1 case acute mixed leukemia, respectively. Of them, 1 case AML secondary to myelodysplastic syndrome, and 36 in first complete remission (CR1), 14 in second complele remission (CR2), 8 in non- remission (NR), 43 cases were refractory or high-risk patients(70.1%). The median age was 14.5 years with the median weight of 45 kg, 49 patients received sUCBT and 9 dUCBT. All the patients conditioned with intensified myeloablative regimen and received a combination of Cyclosporine A(CsA)and mycophenolate mofetil(MMF)to prevent graft- versus- host disease(GVHD).
RESULTS56 out of 58 patients achieved engraftment with implantation rate 96.6%. The median time of ANC≥0.5×10⁹/L was 17(12-37)days, and that of PLT≥20× 109/L 33(17-140)days respectively. 24 cases developed acute GVHD(aGVHD), the incidence rate of grade Ⅱ to Ⅳ aGVHD was 30.4%. The chronic GVHD(cGVHD)was occured in 7 patients of the 49 evaluable patients, all were limited. The estimated 3-year overall survival(OS)and disease-free survival (DFS)were(60.3±6.4)% and(60.1±6.5)% respectively. And the cumulative incidences of 3-year nonrelapse mortality(NRM)and relapse were 33.3% and 9.1% respectively. The 3- year OS rates of AML patients were(66.0 ± 6.7)% for CR and(25.0 ± 15.3)% for NR, differences were statistical significance.
CONCLUSIONFor AML patients, UCBT was conducive to improve outcome with lower incidences of cGVHD and relapse, the patients after transplantation could obtain high quality of life.