Allogeneic hematopoietic stem cell transplantation for chronic myelomonocytic leukemia
10.3760/cma.j.issn.0254-1785.2019.06.005
- VernacularTitle:异基因造血干细胞移植治疗慢性粒单核细胞白血病的临床研究
- Author:
Yuanyuan SHI
1
;
Yi HE
;
Guixin ZHANG
;
Weihua ZHAI
;
Qiaoling MA
;
Aiming PANG
;
Donglin YANG
;
Rongli ZHANG
;
Jialin WEI
;
Erlie JIANG
;
Mingzhe HAN
;
Sizhou FENG
Author Information
1. 中国医学科学院血液病医院(中国医学科学院血液学研究所)实验血液学国家重点实验室国家血液病临床医学研究中心
- Keywords:
Allogeneic hematopoietic stem cell transplantation;
Leukemia;
Splenomegaly
- From:
Chinese Journal of Organ Transplantation
2019;40(6):339-344
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the therapeutic efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in chronic myelomonocytic leukemia (CMML) patients .Methods The clinical data were retrospectively analyzed for 19 CMML patients undergoing allo-HSCT .Engraftment ,graft versus host disease (GVHD ) , infection , relapse , splenomegaly and survival were observed . And the clinical outcomes of allo-HSCT for CMML were analyzed .Results Hematopoiesis reconstitution was not attained in 2 recipients due to early death post-transplantation .Neutrophil engraftment was obtained in 17 recipients with a median time of 14(11-18) days .Neutrophil engraftment and platelet engraftment were achieved in 15 recipients with a median time of platelet engraftment at 15 (12~70) days .Seven patients developed acute GVHD (grade 1 ,n=5;grade 2~4 ,n=3) while another 8 patients had chronic GVHD (extensive ,n=5) . Ten patients (52 .6 % )had palpable splenomegaly (SPM ) before allo-HSCT ,8 patients were diagnosed ultrasonically after transplantation ,all 4 patients without a significant reduction of spleen died while all 4 patients with a significant reduction of spleen survived . After a median follow-up period of 31 (6-68 ) months ,3-year overall survival (OS) ,disease-free survival (DFS) ,cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were (58 .2 ± 12 .5)% ,(36 .3 ± 14)% ,(39 .9 ± 19)% and (37 ± 12 .6)% respectively .Conclusions As an effective therapy for CMML ,allo-HSCT may improve the survival of CMML patients .Palpable SPM pre-transplantation and no significant reduction post-transplantation are probably poor prognostic factor .