HLA-haploidentical Stem Cell Transplantation For Malingnant Hematological Disease

Objective:. To evalute the efficiency of HLA-haploidentical stem cell transplantiation in hematological malignant disease; and assess the influencing factors releted to the disease outcomes.Methods:46 patients with hematological malignant disease were adimmited who underwent HLA-haploidentical stem cell transplantation in our centre during April 2008 to March 2011. The overall survival(OS), relapse-free survival(RFS), transplantation-related mortality(TRM) were analyzed; univariate analysis was made according to age of pateints, graft type, ABO-compatibility or not, donor-recipients gender, donor source and quantity of CD34+ cells.Results:(1) 46 patients were treated by HLA-haploidentical stem cell transplantation, including 14 cases of acute myeloid leukemia,16 cases of acute lymphocyte leukemia, 2 cases of hybrid acute leukemia,5 cases of chronic myeloid leukemia,7 cases of myelodysplasia syndrome,2 cases of lymphoma. Median age at transplantation was 24.5 years, patients male/female ratio was 31/15; 19 cases of graft came from bone marrow and peripheral blood stem cell,27 cases of graft came from peripheral blood stem cell; The median quantity of mononucleated cell was 10.05×10E8/kg, the median quantity of CD34+ cell was 3.05×10E6/kg.(2) The median period of follow-up was 18months,1-year OS was 65.5% (±7.6%),3-year was 65.5%(±7.6%); 1-year RFS was 66.2%(±7.5%),3-year RFS was 66.2%(±7.5%); the cumulative incidence of 100-day TRM was 17.39% (±10.95%),3-year TRM was 26.08%(±9.03%); neutrophil recovery was documented in 100% recipients at a median time of 13.8days (±3.1days) platelet recovery was documented in 93.48% recipients at a meidan time of 18.02days (±9.03days); the cumulative incidence of aGVHD was 65.22%(±13.76%), the cumulative incidence of cGVHD was17.39%(±5.56%); the cumulative incidengce of relapse was 14.29%(±9.35%).(3) Risk factor univariate analysis:the patients was grouped according to age of pateints, graft type, ABO-compatibility or not, donor-recipients gender, donor source and quantity of CD34+ cells. The above factors had no significant impact on neutrophil engraftment, the cumulative incidence of aGVHD,1-year and 3-year OS, the cumulative incidence of 100-day TRM and 3-year TRM. The platelet recovery time was more rapid in bone peripheral blood group versus bone marrow and peripheral blood group(15.36 day vs 21.72 day), thay had statistical difference(P=0.047). The cumulative incidence of cGVHD was higher in female donor/male recipient group versus other group, they had statistical difference(P=0.044).Conclusions:HLA haploidentical stem cell transplantation can be an alternative option for the treatment of high-risk hematological malignant disease, lacking a human leukocyte-matched donor.