Clinical Efficacy of Modified BU/CY as Conditioning Regimen Combined with Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation in Young Acute Myeloid Leukemia Patients with Low or Intermediate Risk.
10.19746/j.cnki.issn.1009-2137.2019.02.008
- Author:
Jian-Hua ZHANG
1
;
Ao-Li ZHANG
1
;
Chun-Xia DONG
1
;
Xiao-Qi QIN
1
;
Rui-Juan ZHANG
1
;
Xiao-Yan GE
1
;
Jian-Min KANG
1
;
Yan-Fei HOU
1
;
Yao-Fang ZHANG
1
;
Jian-Li GUO
1
;
Lin-Hua YANG
2
,
3
Author Information
1. Second Clinical College, Shanxi Metical University; Department of Hematology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
2. Second Clinical College, Shanxi Metical University; Department of Hematology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China,E-mail: yanglh5282@
3. com.
- Publication Type:Journal Article
- MeSH:
Disease-Free Survival;
Hematopoietic Stem Cell Transplantation;
Humans;
Leukemia, Myeloid, Acute;
Retrospective Studies;
Transplantation Conditioning;
Transplantation, Autologous;
Treatment Outcome
- From:
Journal of Experimental Hematology
2019;27(2):360-364
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the safety and efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) using modified BU/CY conditioning regimen for young AML patients of low and middle risk in the first complete remission (CR1).
METHODS:Ten young AML patients of low and middle risk who did not want to accept allogeneic hematopoietic stem cell transplantation（allo-HSCT）and underwent auto-PBHSCT in CR1 during May 2013 to December 2016 were retrospectively analyzed. From 3 months after auto-PBHSCT, the maintenance therapy with interleukin-2 (IL-2) or IL-2 combined with histamine dihydrochloride was performed for these patients in the next 18 months. The side effects of the conditioning regimen, hematopoietic recovery time, transplant-related mortality (TRM) within 100 days and 1 year after auto-PBHSCT, relapse rate, leukemia-free survival (LFS) rate at 2 years and 3 years, overall survival (OS) were evaluated at 3 years and 4 years.
RESULTS:Gastrointestinal side effects were the major non-hematologic toxicity reaction, among which, 7 cases relatively mild and 3 cases displayed moderate, just one case suffered from severe reaction. In 4 cases, the mild liver damage occurred, but no hemorrhagic cystitis occurred. All the patients experienced different kinds of infection, including 5 cases of bloodstream infection, 2 cases of gastrointestinal infection, 3 cases of crissum infection and 2 cases of oral infection. The myeloablative effect occurred in all ten patients. The median times for absolute neutrophil count (ANC)<0.5×10/L and for platelet count <20.0×10/L were 1.5 (0-3) days and 3 (2-5) days after transplantation, respectively. The patients achieved ANC>0.5×10/L at 10 to 19 days, median was 13 days after auto-PBHSCT. The patients achieved platelet count >20×10/L at 10 to 72 days; median was 32 days after auto-PBHSCT. The TRM within 100 days and 1 year after transplantation was 0. The relapse occurred in 2 cases at 6 and 14 months after auto-PBHSCT raspectively. The median follow-up time was 48.1 months, and the median survival time was 54.7 months after transplantation. The 2-year and 3-year LFS were 100% (10 cases) and 80% (8 cases), respectively. The 3-year and 4-year OS were 80% (8 cases) and 70% (7 cases), respectively.
CONCLUSION:Modified BU/CY as conditioning regimen for auto-PBHSCT can achieve the myeloablative effect without raising TRM and obtain good LFS and OS. As for young AML patients without high risk, it is a valuable therapeutic option, especially for those lacking the chance of allo-HSCT.
