A clinical observation of allogeneic peripheral blood hematopoietic stem cells transplantation for acute mono-cytic leukemia

doi:10.3969/j.issn.1674-3806.2013.09.02

Abstract：Objective To study the therapeutic effectiveness and associated complications of allogeneic pe -ripheral blood stem cells transplantation (Allo-PBSCT) in treatment of acute monocytic leukemia (M5 ).Methods Sixteen patients with acute monocytic leukemia received allo-PBSCT,11 patients received PBSCT from human leuco-cyte antigen(HLA)-matched sibling donors and 5 from HLA-matched unrelated donors.Pre-Processing regimen:9 patients were subjected to modified BU/CY2 regimen which was myeloablative , another 7 patients were subjected to FBC regimen which was non-myeloablative.The graft-versus-host disease(GVHD) was prevented by cyclosporin A (CsA),short-term methotrexate(MTX)in 11 patients who received PBSCT from HLA-matched sibling donors, and another 5 patients additionally received antithymocyte globulin (ATG) and mycophenolate mofetil (MMF).A median of 6.58 ×10 8/kg nucleated cells and 4.46 ×10 6/kg CD34+cells were transfused.Results Except for 1 patient died early after transplantation because of hepatic veno-occlusie disease(HVOD).Other 15 patients achieved engraftment confirmed by blood type, chromosome test and DNA polymorphism,with median times of neutrophil >0.5 ×10 9/L and platelet >20 ×10 9/L being 13(9~17)d and 16(8~26)d respectively.Six patients developed acute GVHD (4 developed gradeⅠand 2 developed gradeⅡ).Seven patients experienced local chronic GVHD .Ten patients were found to have disease-free survival(DFS), median of 45 (3~78)months.Conclusion Allo-PBSCT was an effective therapy for acute monocytic leukemia,it was safe and feasible,and long term survival was hoped for patients of this type.