| Objective:To study the effect of unrelated donor hematopoietic stem cell transplantation(URD-HSCT)in treatment of patients with acute lymphoblastic leukemia(ALL).Methods:A retrospective analysis of 44 patients with ALL who received URD-HSCT in the First Affiliated Hospital of Guangxi Medical University from October 2005 to January 2019.Some transplant related indicators,such as hematopoietic reconstitution time,overall survival(OS),disease-free survival(DFS),recurrence rate(RR)and transplant-related mortality(TRM)were analyzed.Results:Among 44 ALL patients,28 males,16 females,the median age at transplant was 21 years(4-43 years).The median follow-up time was 12.9 months(2-160.1 months).All patients received hematopoietic reconstruction.The median time of neutrophil reconstruction was +13(+9~+21d)days,and the median time of platelet reconstruction was +17(+9~+70d)days.At the end of follow-up period,19 survived and 25 died,the 5-year OS and DFS were 41.3% and 40.7%,respectively.Acute graft-versus-host disease(aGVHD)occurred in 10 cases,the incidence of aGVHD was 22.7%,and chronic graft-versus-host disease(cGVHD)in 5 cases,the incidence of cGVHD was 13.9%.10 cases had recurrence after transplantation,the median recurrence time was 6.4 months(2.6-18 months),and the 5-year cumulative recurrence rate was 36.3%.Twelve transplant-related deaths occurred during the follow-up period,of which 9 died of pulmonary infection(9/12),the cumulative transplant-related mortality rate was 27.3%.Univariate analysis showed that gender,age,remission status before transplantation,disease risk stratification,HLA compatibility,pretreatment,GVHD prevention and Philadelphia chromosome did not significantly affect the prognosis of patients(P>0.05).Conclusions:1.URD-HSCT is an effective method for the treatment of acute lymphoblastic leukemia.2.Pulmonary infection is the main cause of transplant-related death. |
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