Short-term effects and long-term prognosis of allogeneic hematopoietic stem cell transplantation in treating acute lymphoblastic leukemia

Abstract：Objective To investigate the short-term effects and long-term prognosis of allogeneic hematopoietic stem cell transplantation in treating acute lymphoblastic leukemia (ALL).Methods Fifty-six cases with ALL treated in our hospital between September 2008 and December 2011 were selected to analyze the short-term and long-term therapeutic effect. COX regression model was used to predict the long-term prognosis.Results Seventeen days after implantation, TRM of 56 cases was 3.5% (2/56), 96.4% of whom(54/56)had successful NE cell implantation. Platelet implantation was not a success in 4 cases. 30 d after implantation, the rate of donor chimerism was 100% in 49 cases, but was 74.2%、49.6%、58.7% respectively in other 3 cases. 12.5%(7/56)of these cases had chronic graft-versus-host disease (GVHD), 20 had acute graft-versus-host disease (Agvhd), and 5 cases had multiple organ Agvhd. 3 months after implantation, 8.9%(5/56)of these cases had TRM death, and relapse rate was 8.9%(12/56). Three-year overall survival was 64.7%, and leukemia-free survival was 61.4%. Single factors that might have influenced long-term prognosis were donor type, morbid state before implantation, myeloid expression, pretreatment dose and ways of transplantation (P>0.05). COX analysis showed that unrelated donors, non-CR status before implantation, and standard pretreatment doses were risk factors for long-term prognosis (P<0.05).Conclusion HSCT has better short-term effects in treating ALL, but the recurrence rate is higher. ALL patients with unrelated donors, non-CR status before implantation, and standard pretreatment doses have a higher recurrence rate.