Haploidentical blood and marrow transplantation for advanced chronic myeloid leukemia
10.3760/cma.j.issn.0254-1785.2012.02.002
- VernacularTitle:亲缘HLA半相合造血干细胞移植治疗进展期慢性髓性白血病
- Author:
Yanli ZHAO
;
Tong WU
;
Yaochen ZHANG
;
Xingyu CAO
;
Yuming YIN
;
Jingbo WANG
;
Jiarui ZHOU
;
Ruijuan SUN
;
Yue LU
;
Jianping ZHANG
;
Shuquan JI
;
Daopei LU
- Publication Type:Journal Article
- Keywords:
Hematopoietic stem cell transplantation;
Leukemia,myeloid,aggressive-phase;
Treatment outcome
- From:
Chinese Journal of Organ Transplantation
2012;33(2):73-76
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the efficacy of haploidentical blood and marrow transplantation (haplo-BMT) in the treatment of advanced chronic myeloid leukemia (CML).MethodsFrom November 2002 to October 2007,35 patients with advanced CML received haplo-BMT.Eleven patients achieved the second chronic phase (CP2) after treatment with imatinib or chemotherapy or both before pre-conditioning,but there were 13 cases in accelerated phase (AP) and 11 patients in blast phase (BP) at the time of transplantation.By the last follow-up date October 31,2011,the median follow-up time among living patients was 67 months (range,49 to 100 months).ResultsThe cases of HLA-antigen mismatched between donors and recipients as 1,2,and 3 antigens were 1,12,and 22 respectively.The number of mean mononuclear cells and CD34+ cells was (7.19+ 1.37) × 108/kg and (2.54± 1.50) × 106/kg,respectively.All but one patient achieved durable hematopoietic reconstitution. Hyperacute graft-versus-host disease (GVHD) occurred in 28.6％ (10/35) patients.The cumulative incidence of grade Ⅱ to Ⅳ acute GVHD was 48％.Among 27 patients who survived longer than 100 days after transplant,16 (60 ％) had chronic GVHD.Fiveyear overall survival (OS) rate was 46.2％ and 45.5％ in CML-AP and BP (P =0.97),respectively.Five-year probability of OS rate was 81.8％,30.8％ and 27.3％ in patients with CML-CP2,CML-AP and BP at transplant,respectively.The OS of CML-CP2 was significantly higher than CML-AP and BP at transplant (P＜0.01 ).ConclusionHaplo-BMT is a feasible therapeutic mean for patients with advanced CML who have no matched donors available.It is better to perform haplo-BMT at CML-CP2 other than CML-AP or BP.
