Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (19): 3585-3588.doi: 10.3969/j.issn.1673-8225.2010.19.035

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Related haploidentical hematopoietic stem cell transplantation for leukemia in four cases

Chen Xiao-xia, Wang Zhi-ming, Luo Xian-sheng, Xu Dan-dan, Li Xing, Lei Mei-qing   

  1. Department of Hematology, Haikou Municipal People’s Hospital, Affiliated to Xiangya School of Medicine, Central South University, Haikou  570208, Hainan Province, China
  • Online:2010-05-07 Published:2010-05-07
  • About author:Chen Xiao-xia, Associate chief physician, Department of Hematology, Haikou Municipal People’s Hospital, Affiliated to Xiangya School of Medicine, Central South University, Haikou 570208, Hainan Province, China chenxia_62@yahoo.com.cn
  • Supported by:

    the Natural Science Foundation of Hainan Province in 2005, No. 80571*;

    the Natural Science Foundation of Hainan Province in 2008, No.30869*

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Abstract:

BACKGROUND: A large amount of investment is needed to establish and maintain an unrelated donor database. Partial matched donors do not need special cost, with strong manipuility.

OBJECTIVE: To evaluate the efficacy of haploidentical (from family member donors) hematopoietic stem cell transplantation for leukemia.

METHODS: Four patients were enrolled at the Department of Hematology, Haikou Municipal People’s Hospital, Affiliated to Xiangya School of Medicine, Central South University from November 2002 to March 2008. All patients received HLA haploidentical (from family member donors) hematopoietic stem cell transplantation. Modified Bu/CY pretreatment was utilized: cytarabine 2.0-3.0 g/(m2•d)×2 d, for 24 consecutive hours via the vein; myleran 4 mg/(kg•d)×3 d; cyclophosphamide 50 mg/(kg•d)×2 d; methyl-cyclohexyl nitrosourea; 25 mg/(m2•d)×1 d; antithymocyte globulin 25 mg/(kg•d)×4 d. We had increased cytarabine dose twice, and changed to a 24-hour vein infusion, so that pre-processing was strengthened, which promoted a lasting hematopoietic stem cell implantation, based on the modified program. Graft-versus-host disease prevention: cyclosporin A and mycophenolate mofetil would be used and advanced to minus 7 days (one day before stem cell transfusion is minus 1) based on the classic methotrexate regimen. The ABO blood type and DNA were detected in patients before and after transplantation.

RESULTS AND CONCLUSION: Detection of hematopoietic reconstitution after transplantation: All four patients had received hematopoietic reconstitution, with no pre-processing-related death. The leukocytes reduced to 0 after -3 to +7 days of hematopoietic stem cell transplantation, and for 2-14 consecutive days, +12 to +20 days leukocytes > 1.0 × 109/L, +20 to +51 days platelets > 20×109/L. Incidence of graft-versus-host disease: GVHD Ⅳ grade (intestinal tract) was found in 1 case, acute graft-versus-host disease grade Ⅱ (intestinal tract) in 1 case, and acute graft-versus-host disease grade Ⅱ (skin) in 1 cases. Above-mentioned results have indicated that it is safe to use related haploidentical hematopoietic stem cell transplantation for leukemia.

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