Efficacy and Safety of Cladribine-based Intensified Conditioning Regimen in Hematopoietic Stem Cell Transplantation in Patients with High-Risk Acute Myeloid Leukemia.
10.19746/j.cnki.issn.1009-2137.2022.01.011
- Author:
Wan-Ying PAN
1
;
Ke-Xin LI
2
;
Hui-Yang WU
2
;
Ying-Zhi HE
2
;
Jing-Wen DU
2
;
Ya-Ling ZHENG
2
;
San-Fang TU
2
;
Chao-Yang SONG
2
;
Yu-Hua LI
2
;
Yu-Xian HUANG
3
Author Information
1. Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China,Department of Hematology, Yuebei People's Hospital, Shaoguan 512025, Guangdong Province, China.
2. Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China.
3. Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, Guangdong Province, China,E-mail: hyx6610@163.com.
- Publication Type:Journal Article
- Keywords:
allogeneic hematopoietic stem cell transplantation;
cladribine;
high-risk acute myeloid leukemia;
intensified conditioning regimen
- MeSH:
Busulfan;
Cladribine;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation;
Humans;
Leukemia, Myeloid, Acute/therapy*;
Retrospective Studies;
Transplantation Conditioning
- From:
Journal of Experimental Hematology
2022;30(1):65-71
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the efficacy, safety and the risk factors affecting prognosis of high-risk acute myeloid leukemia (AML) patients treated by cladribine-based intensified conditioning regimen.
METHODS:The clinical data of 28 patients with high-risk AML treated by cladribine in combination with busulfan plus cyclophosphamide (BuCy) intensified conditioning regimen before allogeneic hematopoietic stem cell transplantation (allo-HSCT) in Zhujiang Hospital, Southern Medical University from October 2016 to June 2020 were analyzed retrospectively. The overall survival (OS) rate, cumulative progression-free survival (PFS) rate, relapse rate, non-relapse mortality (NRM), regimen related toxicity (RRT) and risk factors affecting prognosis of the patients were analyzed.
RESULTS:The 1-year OS and PFS of the patients after implantation was (78.8±8.6)% and (79.8±8.1)%, while the 1-year cumulative relapse rate and NRM of the patients was 9.3% and 22.0%, respectively. The 1-year expected OS of MRD- high-risk patients before HSCT was 100%. The 1-year expected OS and PFS of the patients in pre-transplant relapse group was (46.9±18.7)% and (50.0±17.7)%, respectively. The incidence of I/II grade RRT was 39.3%. NO III/IV grade RRT were found in 28 patients. Multivariate analysis showed that pre-transplant relapse was the independent risk factor affecting OS and PFS of the patients.
CONCLUSION:The intensified conditioning regimen of cladribine in combination with BuCy can reduce the relapse rate of high-risk AML transplantation, and its RRT is mild, exhibiting good safety. MRD- high-risk patients before HSCT can achieve better transplant benefits, but the prognosis of patients with relapse before transplantation is not significantly improved. Therefore, for non-relapsed high-risk AML patients, this intensified conditioning regimen deserves to be considered.
