The efficacy analysis of allogeneic hematopoietic stem cell transplantation in 48 leukemia patients with central nervous system leukemia.
10.3760/cma.j.issn.0253-2727.2019.07.008
- VernacularTitle:异基因造血干细胞移植治疗合并中枢神经系统白血病48例疗效分析
- Author:
Xin Hong FEI
1
;
Jiang Ying GU
;
Yu Ming YIN
;
Hao Yu CHENG
;
Wei Jie ZHANG
;
Shu Qin ZHANG
;
Jie ZHAO
;
Jing Bo WANG
Author Information
1. Department of Hematology, Aerospace Central Hospital, Beijing 100049, China.
- Publication Type:Journal Article
- Keywords:
Central nervous system;
Hematopoietic stem cell transplantation;
Leukemia;
Total-body irradiation
- MeSH:
Central Nervous System Neoplasms/therapy*;
Child;
Hematopoietic Stem Cell Transplantation;
Humans;
Leukemia, Myeloid, Acute/therapy*;
Remission Induction;
Retrospective Studies;
Survival Rate;
Transplantation Conditioning
- From:
Chinese Journal of Hematology
2019;40(7):578-583
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of leukemia patients also suffering from central nervous system leukemia (CNSL) . Methods: A total of 48 leukemia patients with central nervous system leukemia admitted to our hospital from May 2012 to December 2017 were retrospectively analyzed. Results: ① Including 22 cases of acute lymphocytic leukemia (ALL) , 21 cases of acute myeloid leukemia (AML) , and 5 cases of chronic myelogenous leukemia (CML) . Before transplantation, 19 patients achieved complete remission (CR) , and the rest 29 ones without remission. ②The conditioning regimen used TBI as the main protocol, and 6 patients were combined with whole brain and total spinal cord radiotherapy, 2 with Cyber knife treatment, and children with modified IDA combined with BUCY. ③All 48 patients were successfully transplanted, the median time for leukocyte engraftment was 14 (10-23) days, the median time for platelet transplant 16 (6-78) days. ④Bone marrow was evaluated 28 days after transplantation, all 48 patients reached CR, and DNA testing confirmed that they were all full donor chimerism. ⑤The median follow-up was 14 (2-69) months. Of them, 28 cases survived, 10 relapsed and the rest 3 had recurrence of CNSL after transplantation. One year after allo-HSCT, the overall survival (OS) of CR and non-CR groups were (77.3±10.0) % and (57.6±9.3) % (P=0.409) , respectively, the disease-free survival rates (DFS) were (71.2±11.0) % and (53.9±9.5) % (P=0.386) , respectively. The 1-year OS rates of ALL and AML groups after transplantation were (54.2±10.7) %, (80.1±8.9) %, respectively (P=0.200) , and DFS rates were (49.2±10.8) %, (75.0±9.7) % (P=0.190) , respectively. Conclusion: Allo-HSCT was safe and effective for leukemia patients with CNSL.
