Haploidentical hematopoietic stem cell transplantation for leukemia in 23 cases

Jiang Qu; Zhang Hong-bin; Yang Li; Luo Hong; Miao Qiao; Deng Xue-mei

doi:10.3969/j.issn.2095-4344.2016.28.017

Abstract：BACKGROUND:Al ogeneic hematopoietic stem cel transplantation (HSCT) is one of the effective methods in the treatment of leukemia. The haploidentical HSCT is an option for the patients who need a HSCT without a human leukocyte antigen (HLA)-matched donor. OBJECTIVE:To study the clinical efficacy of HLA-haploidentical HSCT on leukemia and its complications. METHODS:A total of 23 patients (4 cases of acute lymphoblastic leukemia, 12 of acute myelogenous leukemia, and 7 of chronic granulocytic leukemia) who had been treated with HLA-haploidentical HSCT from November 2007 to March 2015 were enrol ed. Conditioning regimen I was set as cyclohexyl nitrosourea+cytarabine+busulfan+cyclophosphamide; regimen II as cyclophosphamide+total body irradiation;regimen III as fludarabine+cytarabine+busulfan+cyclophosphamide; and regimen IV as busulfan+cyclophosphamide. Cyclosporin A, mycophenlate mofetil, antithymocyte globulin and methotrexate were used to prevent graft-versus-host disease (GVHD). Hematopoietic remodeling, complications and prognosis were observed in al patients undergoing HLA-haploidentical HSCT. RESULTS AND CONCLUSION:Of the 23 patients, 22 achieved reconstitution of the granulocyte series, and 19 achieved reconstruction of the megakaryocyte series. Additional y, there were 7 cases of acute GVHD and 4 of chronic GVHD. Transplant-related mortality was 22%(5/23) within 100 days post transplantation including graft failure, acute GVHD, intracranial hemorrhage and disseminated infections. There were 14 cases of disease-free survival from 100 days to 24 months post transplantation, 2 cases of death due to GVHD and fungal infection, or recurrence and chronic GVHD, and 2 cases of recurrence under treatment. These findings indicate that HLA-haploidentical HSCT is an effective approach for the treatment of patients with leukemia, which is worth further investigation in clinical practice.