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[Clinical study of allogeneic hematopoietic stem cell transplantation for relapsed/refractory acute lymphocytic leukemia].
Zhonghua Xue Ye Xue Za Zhi. 2009 Feb; 30(2):73-6.ZX

Abstract

OBJECTIVE

To explore the efficacy and toxicity of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for relapsed/refractory acute lymphocytic leukemia (ALL).

METHODS

Forty-seven patients with relapsed/refractory ALL received allo-HSCT, which containing 19/47 from HLA-identical sibling donors (sib-HSCT), 18/47 from HLA-identical unrelated donors (URD-HSCT) and 10/47 from haplo-identical donors (Hi-HSCT). Conditioning regimens included "TBI plus Cyclophosphamide (Cy) (42/ 47)" or "busulfan (Bu) plus Cy (5/47)". Cyclosporine (CsA) combined with a short-course Methotrexate (MTX) were used for graft versus host disease (GVHD) prophylaxis. In addition, patients receiving URD-HSCT or Hi-HSCT were given mycophenolate mofetil (MMF) and anti-thymocyte immunoglobulin (ATG). Patients with molecular or cytogenetic relapse tendency on minimal residual disease (MRD) monitoring received donor lymphocyte infusion (DLI).

RESULTS

All patients tolerated the therapy well except for mucositis. Renal dysfunction occurred in 2 patients on CsA therapy. Epilepsy occurred in 1 patient, fatal infectious complications in 9 (including 3 interstitial pneumonia), grade III-IV acute GVHD (aGVHD) in 7, chronic GVHD (cGVHD) in 22 and hemorrhagic cystitis (HC) in 4 patients. Thirteen patients relapsed after transplantation. The median time of hematopoietic reconstitution was + 17 ds. Nineteen patients received DLI, and 6 of them had no disease progression. With a median follow-up duration of 43 (10-77) months, the estimated 5-year overall survival (OS) and disease free survival (DFS) rates were 49.65% and 46.55%, respectively.

CONCLUSION

Allo-HSCT is an effective therapy for relapsed/refractory ALL. Relapse after transplantation, fatal infection, and severe acute GVHD are the main causes for failure. DLI might decrease the relapse rate after transplantation.

Authors+Show Affiliations

Department of Hematology, Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Haemostasis, Ministry of Health, Suzhou 215006, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Research Support, Non-U.S. Gov't

Language

chi

PubMed ID

19563014

Citation

Ma, Xiao, et al. "[Clinical Study of Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed/refractory Acute Lymphocytic Leukemia]." Zhonghua Xue Ye Xue Za Zhi = Zhonghua Xueyexue Zazhi, vol. 30, no. 2, 2009, pp. 73-6.
Ma X, Wu DP, Sun AN, et al. [Clinical study of allogeneic hematopoietic stem cell transplantation for relapsed/refractory acute lymphocytic leukemia]. Zhonghua Xue Ye Xue Za Zhi. 2009;30(2):73-6.
Ma, X., Wu, D. P., Sun, A. N., Fu, Z. Z., Tang, X. W., Wu, X. J., Liu, Y. J., Qiu, H. Y., Miao, M., Han, Y., Jin, Z. M., Zhao, Y., Xue, S. L., Wang, Y., Chen, S. N., He, G. S., Zhou, H. X., & Chang, H. R. (2009). [Clinical study of allogeneic hematopoietic stem cell transplantation for relapsed/refractory acute lymphocytic leukemia]. Zhonghua Xue Ye Xue Za Zhi = Zhonghua Xueyexue Zazhi, 30(2), 73-6.
Ma X, et al. [Clinical Study of Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed/refractory Acute Lymphocytic Leukemia]. Zhonghua Xue Ye Xue Za Zhi. 2009;30(2):73-6. PubMed PMID: 19563014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical study of allogeneic hematopoietic stem cell transplantation for relapsed/refractory acute lymphocytic leukemia]. AU - Ma,Xiao, AU - Wu,De-pei, AU - Sun,Ai-ning, AU - Fu,Zheng-zheng, AU - Tang,Xiao-wen, AU - Wu,Xiao-jin, AU - Liu,Yue-jun, AU - Qiu,Hui-ying, AU - Miao,Miao, AU - Han,Yue, AU - Jin,Zheng-ming, AU - Zhao,Ye, AU - Xue,Sheng-li, AU - Wang,Ying, AU - Chen,Su-ning, AU - He,Guang-sheng, AU - Zhou,Hai-xia, AU - Chang,Hui-rong, PY - 2009/7/1/entrez PY - 2009/7/1/pubmed PY - 2010/5/28/medline SP - 73 EP - 6 JF - Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi JO - Zhonghua Xue Ye Xue Za Zhi VL - 30 IS - 2 N2 - OBJECTIVE: To explore the efficacy and toxicity of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for relapsed/refractory acute lymphocytic leukemia (ALL). METHODS: Forty-seven patients with relapsed/refractory ALL received allo-HSCT, which containing 19/47 from HLA-identical sibling donors (sib-HSCT), 18/47 from HLA-identical unrelated donors (URD-HSCT) and 10/47 from haplo-identical donors (Hi-HSCT). Conditioning regimens included "TBI plus Cyclophosphamide (Cy) (42/ 47)" or "busulfan (Bu) plus Cy (5/47)". Cyclosporine (CsA) combined with a short-course Methotrexate (MTX) were used for graft versus host disease (GVHD) prophylaxis. In addition, patients receiving URD-HSCT or Hi-HSCT were given mycophenolate mofetil (MMF) and anti-thymocyte immunoglobulin (ATG). Patients with molecular or cytogenetic relapse tendency on minimal residual disease (MRD) monitoring received donor lymphocyte infusion (DLI). RESULTS: All patients tolerated the therapy well except for mucositis. Renal dysfunction occurred in 2 patients on CsA therapy. Epilepsy occurred in 1 patient, fatal infectious complications in 9 (including 3 interstitial pneumonia), grade III-IV acute GVHD (aGVHD) in 7, chronic GVHD (cGVHD) in 22 and hemorrhagic cystitis (HC) in 4 patients. Thirteen patients relapsed after transplantation. The median time of hematopoietic reconstitution was + 17 ds. Nineteen patients received DLI, and 6 of them had no disease progression. With a median follow-up duration of 43 (10-77) months, the estimated 5-year overall survival (OS) and disease free survival (DFS) rates were 49.65% and 46.55%, respectively. CONCLUSION: Allo-HSCT is an effective therapy for relapsed/refractory ALL. Relapse after transplantation, fatal infection, and severe acute GVHD are the main causes for failure. DLI might decrease the relapse rate after transplantation. SN - 0253-2727 UR - https://www.unboundmedicine.com/medline/citation/19563014/[Clinical_study_of_allogeneic_hematopoietic_stem_cell_transplantation_for_relapsed/refractory_acute_lymphocytic_leukemia]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0253-2727&year=2009&vol=30&issue=2&fpage=73 DB - PRIME DP - Unbound Medicine ER -