Clinical Study Of Allogeneic Hematopoietic Stem Cell Transplantation For Leukemia Patients Not In Complete Remission

Objective: To investigate the therapeutic efficacy of allogeneic hematopoietic stemcell transplantation (allo-HSCT) for patients with leukemia failing to achieve remissionwith chemotherapy, and pretransplantation prognostic factors.Method: We retrospectively analyzed43cases of leukemia patients not in remissionundergoing allo-HSCT from2000to2011, and pretransplantation prognostic factors thataffect long-term disease free survival (DFS) were evaluated by univariate andmultivariate analysis using a Cox regression.Results: Fourteen of43patients remain alive so far, and the3-year probability of DFSwas30.1%;29patients died of transplant-related complications (30.2%) or relapse(37.2%). Univariate analysis showed that acute myeloid leukemia (AML), blast cells inbone marrow <30%and time from relapse to transplantation <3months were the majorprognostic factors which were associated with better DFS, and multivariate analysisshowed that only time from relapse to transplantation was identified as being anindependent prognostic factor.Conclusion: These data showed that some patients who were characterized byleukemia type of acute myeloid leukemia, fewer marrow blasts (<30%) and time fromrelapse to transplantation less than3months might benefit from immediate allo-HSCTwithout prior reinduction attemps. Therefore, we recommend immediate allo-HSCT topatients failing to achieve complete remission if donor is available. The patients hadbetter outcome if the pretransplatation prognostic factors were used for selection ofpatients,...