Clinical Study Of Allo-HSCT With FLAG Conditioning Regimen In The Treatment Of Children High Risk Acute Leukemia

Objective: The FLAG with the BUCY regimen are be used in preconditioning of children high-risk acute leukemia before allo-HSCT in our study.To Investigate the security and efficacy of FLAG conditioning regimen and to explore its application value in the treatment of children high-risk acute leukemia.Methods: We retrospectively analyzed 31 children with high risk acute leukemia who were treated with allo-HSCT in Department of Hematology,the Affiliated Children's Hospital of Suzhou University,From April 8th 2011 to August 19 th 2017.FLAG combined with BUCY regimen was given before allo-HSCT.The time of hematopoietic reconstitution,time and the degree of acute and chronic GVHD,Post-transplant infection(CMV?EBV),transplant related complications(VOD,HC),postoperative recurrence and survival were observed.Spss21.0 is used to describe the sample data.OS?DFS?the cumulative incidence of GVHD and recurrence rate were analyzed by kaplan-meier method and the survival curve was drawn.The survival rate was compared with log-rank test.Fisher exact probability method was used to compare the composition ratio between the two groups.The difference It will be considered statistically significant diffent if P<0.05.Results: 1.30 out of 31 patients achieved hematopoietic reconstitution after transplantation.The median reconstitution time of granulocyte hematopoiesis was 13(10-31)days.The median time of hematopoietic reconstitution in megakaryocytes was 19(7-167)days.2.At the end of the follow-up period,the 5years overall survival rate of all the children was 93.1%.The 5years disease-free survival rate is 90%.The cumulative recurrence rate is 10%.The median survival time was 13(1-79)months.Transplantationrelated mortality rate was 0.3.The cumulative incidence of aGVHD(acute graft-versus-host disease)was 64.5%,the median time of occurrence is 17(7-47)days,The cumulative incidence of cGVHD(chronic graft-versus-host disease)was 12.8%(3 cases),Occurred at 182 d,187d and 280 d after transplantation,The infection rate of CMV was 48.4%(15 cases).The infection rate of EBV was 22.6%(7cases).The incidence of hemorrhagic cystitis was 16.1%.No hepatic vein occlusion was found in all the children after transplantation.Conclusion: For high risk acute leukemia children with FLAG conditioning regimen,it has the advantage of high implantation rate,early hematopoietic reconstitution,and fewer transplant related complications.FLAG conditioning regimen has certain clinical application value.