Therapeutic efficacy of second allo-HSCT for aplastic anemia after failure of first allo-HSCT.
10.7534/j.issn.1009-2137.2014.05.032
- Author:
Feng ZHU
1
;
Hui-Ren CHEN
2
;
Zhi GUO
3
;
Xiao-Dong LIU
3
;
Xue-Peng HE
3
;
Jing-Xing LOU
3
;
Kai YANG
3
;
Yuan ZHANG
3
;
Peng CHEN
3
Author Information
1. Clinical Medical College of Anhui Medical University, General Hospital of Beijing Military Command, Beijing 100700, China.
2. Clinical Medical College of Anhui Medical University, General Hospital of Beijing Military Command, Beijing 100700, China. E-mail: chenhui-ren@medmail.com.cn.
3. Department of Hematology, General Hospital of Beijing Military Command, Beijing 100700, China.
- Publication Type:Journal Article
- MeSH:
Allografts;
Anemia, Aplastic;
therapy;
Antilymphocyte Serum;
Cyclosporine;
Disease-Free Survival;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation;
Humans;
Methotrexate;
Mycophenolic Acid;
analogs & derivatives;
Retrospective Studies
- From:
Journal of Experimental Hematology
2014;22(5):1348-1353
- CountryChina
- Language:Chinese
-
Abstract:
This study was purposed to evaluate the curative efficacy of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) after failure of the first allo-HSCT in aplastic anemia patients, the cause of implant failure after allo-HSCT and clinical data of 10 severe aplastic anemia (SAA) patients in the second allo-HSCT were retrospectively analyszed. The second HSCT conditioning programs include: cyclophosphamide (CTX) + fludarabine (FLU)+ anti-thymocyte globulin (ATG) combination chemotherapy for 3 cases; CTX + FLU + white busulfan (Bu) + ATG combination chemotherapy for 7 cases. The prevention regimen of graft-versus-host disease (GVHD) include cyclosporine (CsA), mycophenolate mofetil (MMF) and methotrexate (MTX). The median count of mononuclear cell infusion was 12.17 (5.99-18.12)×10(8)/kg. The CD34(+) cell count was 5.2 (3.8-10.9)×10(6)/kg. The results showed that 10 evaluable patients achieved hematopoietic reconstitution with absolute neutrophil >0.5×10(9)/L, platelets >20×10(9)/L at 15d (8-21d) and 17d (11-27d) after transplantation. The grade I aGVHD occurred in 2 case, grade II in 1 case, chronic GVHD in 3 cases. Transplant-related deaths occurred in 4 cases. The disease-free survival rate, transplant-related mortality, GVHD after transplantation were 60%, 40% and 50% respectively. It is concluded that the second allo-HSCT is an effective therapy for aplastic anemia after allo-HSCT implant failure.
