| ObjectivesTo observe the clinical efficacy of related haploidentical peripheral blood stem cell transplantation for treatment of refractory and relapsed acute leukemia.MethodsThe clinical data of refractory and relapsed acute leukemia of our 57 cases who accept related haploidentical peripheral blood stem cell transplantation was retrospectively analyzed,including 43 cases of acute lymphoblastic leukemia(ALL),14 cases of acute myeloid leukemia(AML).Haploidentical peripheral blood stem cell transplantation using “modified Bu/Cy+ATG”;applying “cyclosporine A +mycophenolate mofetil + Short-range methotrexate ± Basiliximab” to prevent graft-versus-host disease.Collect statistics in the process of transplantation,including infection rate of granulocyte lack period 、 neutrophil reconstruction and platelet engraftment 、 the incidence of GVHD and hemorrhagic cystitis 、 the recurrence rate after transplantation 、nonrelapse mortality during 3 years、3 years expected disease-free survival and overall survival.Results57 refractory and relapsed acute leukemia cases were followed for an median of15 months(1-65 months),infection rate during granulocyte lack period was 84.2%(48/57);neutrophil reconstruction rate was 98.2%(56/57),the median implanted time was 14d(10d-22d),platelet engraftment was 91.2%(52/57),the medianimplanted time was 20d(10d-93d);the incidence of GVHD was 61.4%(35/57),including the incidence of aGVHD 26.3%(15/57)and cGVHD 35.1%(20/57);the incidence of hemorrhagic cystitis was 36.8%(21/57);the recurrence rate after transplantation was 24.6%(14/57),nonrelapse mortality was 29.8%(17/57);2 cases got posttransplant lymplaoproliferative disease;three years expected disease free survival was 39%,tree years expected overall survival was 43.5%。ConclusionsIn the absence of HLA-identical siblings donors and unrelated donors,related haploidentical peripheral blood stem cell transplantation for treatment of refractory and relapsed acute leukemia is an effective and feasible method. |
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