Hematopoietic Stem Cell Transplantation (HSCT) In The Treatment Of Malignant Hematological Diseases

Objective: To evaluate the clinical efficacy and complication of hematopoietic stem cell transplantation ( HSCT ) in the treatment of malignant hematological diseases. Methods: 20 patients with malignant hematological diseases received HSCT, including 10 cases of Auto-HSCT and 10 cases of Allo-HSCT 9 donors were HLA-identical siblings, 1 donor was HLA-haploidentical sibling. Conditioning regimen included: Busulfan/ Cyclo- phosphamide ( Bu/Cy ) , Melphalan/ Etoposide/Cytarabine/Cyclophos-phamide , Fludara- bine/Melphalan/ Cytarabine/ Cyclophosphamide, BCNU/Etoposide/Cytarabine/Cyclophos- phamide, HD-Melphalan. Results: All the patients engrafted gained hematopoietic reconstitution. The time when the absolute neutrophil count (ANC ) 2=0.5 × 10~9/L was achieved in 11.2 ( +9-+13 ) days and 14.5 ( +10-+18 ) days, platelet count > 20 × 10~9/Lin 15.7 (+9~+25 ) days and 18.3 (+12-+30) days, respectively in Auto-HSCT and Allo-HSCT, 17 cases developed infection (17/20 )and 1 case developed hemorrhagic cystitic( HC)(1/20). No interstitial pneumonia ( IP ) and hepatic veno-occlusive disease ( VOD ) occurred. Acute graft-versus-host disease (GVHD) was observed in 5 cases (5/10) and chronic GVHD was observed in 6 cases (6/10) . The blood type of 4 patients whose ABO blood type is mismatched was turned into donor-type in 3 months after Allo-HSCT. All patients of Allo-HSCT achieved full donor-type engraftment proved by DNA order analysis on day 28 after Allo-HSCT. The follow-up duration was 3 to 23 months, 3 cases( 3/10 ) relapsed and 3 cases ( 3/10 ) died in Auto-HSCT group. But there was no relapse and death in Allo-HSCT group.Conclusion: K The incidence of IP, VOD and HC can be significantly decreased by efficient preventive measures.2, HLA-haploidentical Allo-HSCT is effective and safe relatively, it will overcome the difficulty about absence of donor. 3, Allo-HSCT is the most effective method in the treatment of malignant hematological diseases at present, and the relapse rate of disease in Auto-HSCT is high.