Efficacy Analysis of Unrelated Cord Blood Transplantation for High-Risk Refractory AML1-ETO Positive Myeloid Leukemia.
10.19746/j.cnki.issn.1009-2137.2019.04.042
- Author:
Jia-Rong REN
1
;
Xiao-Yu ZHU
1
;
Bao-Lin TANG
1
;
Xiang WAN
1
;
Juan TONG
1
;
Lei ZHANG
1
;
Xu-Han ZHANG
1
;
Kai-Di SONG
1
;
Wen YAO
1
;
Guang-Yu SUN
1
;
Hui-Lan LIU
2
;
Zi-Min SUN
1
Author Information
1. Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui province, China.
2. Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, Anhui province, China,E-mail: 13866771269@163.com.
- Publication Type:Journal Article
- MeSH:
Cord Blood Stem Cell Transplantation;
Core Binding Factor Alpha 2 Subunit;
Graft vs Host Disease;
Humans;
Leukemia, Myeloid, Acute;
Mycophenolic Acid;
Oncogene Proteins, Fusion;
Peripheral Blood Stem Cell Transplantation;
RUNX1 Translocation Partner 1 Protein;
Transplantation Conditioning
- From:
Journal of Experimental Hematology
2019;27(4):1246-1252
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To analyze the clinical outcomes of engraftment, graft-versus-host disease (GVHD) and survival in the patients with AML1-ETO positive acute myeloid leukemia (AML) treated with unrelated umbilical cord blood transplantation (UCBT).
METHODS:Forty-Five patients with high-risk refractory AML1-ETO positive AML were treated with a single UCBT in a single center from July 2010 to April 2018. All the patients underwent a myeloablative preconditioning regimen，and cyclosporine A (CSA) combined with mycophenolate mofetil (MMF) was used to prevent GVHD.
RESULTS:The median value of total nucleated cells (TNC) in cord blood was 5.21 (1.96-12.68)×10/kg recipient body weight, and that of CD34+ cells was 5.61 (0.56-15.4)×10/kg recipient weight. The implantation rate of neutrophil at 42 d and that of platelet at 120 d were 95.6% and 86.7%, respectively. The median time of absolute neutrophil count (ANC)＞0.5×10/L and platelet 20×10/L were 16 (12-18) d and 37 (17-140) d after transplantation, respectively. The cumulative incidence of Ⅰ -Ⅳ grade acute GVHD (aGVHD) at 100 d after transplantation was 48.9% (95% CI 33.5%-62.6%), Ⅱ-Ⅳ grade aGVHD occurred in 12 cases (33.3%) (95% CI 20%-47.2%) , and Ⅲ-Ⅳ grade a GVHD in 8 cases (20%) (95% CI 9.8% -32.8%). In 5 cases of 40 patients survived over 100 days, the chronic GVHD (cGVHD) occurred after transplantation, among which 4 were localized, and 1 was extensive. 3 patients relapsed, and the 2-year cumulative relapse rate was 9.5% (95% CI 2.4%-22.8%). The median follow-up time was 23.5 (0.9-89.67) months, 10 patients died, 2-year disease-free survival rate (DFS) was 72.7%, and overall survival rate (OS) was 75.5%. Multivariate analysis showed that Ⅲ-Ⅳ. acute GVHD (aGVHD) affected overall survival.
CONCLUSION:UCBT is an effective rescue treatment for patients with high-risk refractory AML1-ETO positive AML.
