Influence of minimal residual disease before transplantation on outcome of haploidentical hematopoietic stem cell transplantation for high-risk acute lymphoblastic leukemia
10.3760/cma.j.issn.0254-1785.2018.06.005
- VernacularTitle:移植前微小残留病对高危急性淋巴细胞白血病单倍体HSCT疗效的影响
- Author:
Yehui TAN
1
;
Xiaoliang LIU
;
Yu LIU
;
Yazhe DU
;
Ming ZHANG
;
Yunwei ZHANG
;
Jia LI
;
Long SU
;
Mengmeng LIU
;
Sujun GAO
Author Information
1. 吉林大学第一医院血液科
- Keywords:
Acute lymphoblastic leukemia;
High-risk;
Hematopoietic stem cell transplantation;
Minimal residual disease
- From:
Chinese Journal of Organ Transplantation
2018;39(6):344-349
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effect of haploidentical hematopoietic stem cell transplantation (HID-HSCT) on high-risk acute lymphoblastic leukemia (ALL),and to explore the influence of minimal residual disease (MRD) before transplant on the outcomes.Methods A retrospective analysis was performed on 39 high risk ALL patients receiving HID-HSCT in our hospital from Jan.2013 to Jan.2018.The clinical features,stem cell engraftment,complications,survival and recurrence were compared between patients with pretransplant MRD + and MRD-.Results All the 39 patients presented with successful engraftment.The overall survival (OS) was 54.67％;the disease free survival (DFS) was 40.96％;the incidence rate of acute graft versus host disease (aGVHD) was 53.8％,including 23.1％ Ⅱ-Ⅳ degree aGVHD and 2.6％ Ⅲ-Ⅳ degree aGVHD.There was no significant difference in stem cell engraftment,GVHD,cytomegalovirus infection and hemorrhagic cystitis between MRD + and MRD-patients.DFS and OS in MRD + patients were significantly lower than those in MRD-patients;the cumulative RR rate increased significantly,and there was no significant difference in cumulative TRM.Conclusion HID-HSCT was an effective method to treat high-risk ALL,but MRD + patients had high recurrence rate and poor prognosis.Strategy adjustment should be considered to reduce tumor residual and the transplantation strategy should be optimized for these kinds of high risk patients,so as to improve long-term outcomes.
