Clinicalanalysis Of Allo-HSCT For Adult Relapsed / Refractoryacute Myeloid Leukemia

OBJECTIVE To evaluate the curative effect and complications of allo-HSCT in the adult relapsed / refractory acute myeloid leukemia.METHODS We retrospectively analyzed 13 cases of adult relapsed /refractory acute myeloid leukemia undergoing allo-HSCT from Dec 2009 to Jun 2014 in our department.The hematopoietic stem cell engraftment time, the incidence of acute and chronic complications were observed.Follow-up was performed to December 2015 after treatment to observe the patients’ survival. Kaplan-Meier analysis was used to result in overall survival(OS),leukemi-free survival(LFS) and cumulative relapse rate(RR).RESULTS Nine patients obtained hematopoietic reconstitution, the median time to neutrophil engraftment was D + 11(+ 7 ~ + 15), the median time to platelet engraftment was D + 12(+ 7 ~ + 34), The median follow-up time was 16(2~59) months. The Short Tandem Repeat(STR) in bone marrow were donors gene type after transplantation 30 days in all patients. Hemorrhagic cystitis, a GVHD, pulmonary infection, c GVHD,cytomegalovirus were observed in 2 case,7 cases, 3cases, 6 cases, 5 cases.5patients have relapsed and died,one patient died of pulmonary fungal infection and c GVHD, One patient died of circulatory failure; two patients survived with leukemia,the other 4 patients survived up to now without disease progression.The 3-year estimates of OS,LFS,RR were46.2%,30.7%,53.8%.CONCLUSION Allo- HSCT is an effective treatment of adult relapse/refractory AML, About 30.7% patients can achieve long-term survival, but there is still a high recurrence rate after transplantation, while strengthening the GVL effect to improve the curative effect of relapse/refractory AML patients.