Abstract:

BACKGROUND: Myelodysplastic syndromes (MDS), a series of heterogenicity myeloblastic tumor, have transformed to leucemia easily. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only possible treatment for curing this disease.
OBJECTIVE: To observe the therapeutic effect and complication of human leucocyte antigen (HLA)-mismatched HSCT for MDS, and to evaluate the outcome and safety of this treatment.
METHODS: A total of 15 patients with MDS were treated with HLA-mismatched HSCT. The conditioning regimen contained arabinosylcytosin, busulfan, fludarabine and methyl chlorethyl-cyclohexyl-nitrosourea. Antithymocyte globulin, ciclosporin A, mycophenolate mofetil and methotrexate were used for preventing graft versus host disease (GVHD).
RESULTS AND CONCLUSION: Among 15 patients, 14 received hematopoietic recovery after HSCT. The median time of granulocyte recovery ≥ 0.5×109/L and platelets ≥ 20×10⁹/L were day 16 and day 20 respectively. One patient accepted the second time HSCT after failing of the first treatment, and received hematopoietic recovery on day 14 following transplantation. A total of 14 cases survived for a median of 14 (1-36) months, and one died from pulmonary infection, accumulated survival rate was 93.3%. One patient relapsed in 12 months after HSCT, and received complete remission after accepted donor lymphocyte infusion and chemotherapy. Eight patients occured acute GVHD (aGVHD) after HSCT, resulting in the incidence rate of 57.1%. Two of them were controlled after treatment with immunodepressant, and the remaining six developed chronic GVHD (cGVHD). Results suggested that HSCT is an effective treatment for MDS patients, and a majority of patients can survive for a long time.