Abstract:

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is the main therapy of leukemia. The haploidentical hematopoietic stem cell transplantation can expand the application of the transplantation.
OBJECTIVE: Observe the effect of “modi?ed Bu/Cy+ATG” conditioning regimen of haploidentical hematopoietic stem cell transplantation for patients with high-risk leukemia.
METHODS: Nineteen patients with high-risk leukemia received a “modi?ed Bu/Cy+ATG” conditioning regimen: peripheral blood stem cells transplantation in 5 cases, and peripheral blood and bone marrow stem cells transplantation in 14 cases. Methotrexate, cyclosporine A, mycophenolate mofetil were used to prevent graft-versus-host disease (GVHD). Prostaglandin E1 was applied to prevent liver veno-occlusive disease (VOD).
RESULTS AND CONCLUSION: ①Short term effect: the median neutrophil recovery time was 12 (8-20) d; the median platelet recovery time was 13 (10-31) d, and all the patients were successfully implanted. Transplant-related mortality rate was (15.8±8.4)% within 100 days after transplantation. ②GVHD incidence: the overall incidence of Ⅰ- Ⅳdegree of acute GVHD was (63.1±11.1)%, the incidence of chronic GVHD was (54.54±15.0)%. ③Long-term effect: 2-year disease-free survival rate was (28.2±15.5)%. 2-year overall survival rate was (46.9±16.5)%. For the patient with high-risk leukemia, who has not a HLA-matched related or unrelated donor but needs a salvage transplant, the haploidentical hematopoietic stem cell transplantation with “modi?ed Bu/Cy+ATG” conditioning regimen is a feasible selection.