Reduced-intensity Conditioning Regimen In HLA-hapl Oidentical Hematopoietic Stem Cell Transplantation Tre Atment Of Hematologic Malignancies:4 Cases Report And Literature Review

Objective:Discussions the reduced-intensity conditioning the basis of genetic HLA-haploidentical hematopoietic stem cell transplantation (RIC-haplo-HSCT) treatment of Hematologic malignancies is feasibility, safety and efficacy.Methods:From February 2013 to December 2014 at the First Affiliated Hospital of Xinjiang Medical University RIC-haplo-HSCT treatment of four patients, there are fludarabine (Flu)+busulfan (Bu)+Cytarabine (Ara-C)+anti-thymocyte globulin (ATG) based on the reduced-intensity conditioning (RIC):Flu 30mg/m2/dx5d(-9 d～-5d), Bu 3.2mg/kg/dx2d(-4d～-3d), Ara-C 1g/m2×5d (-9 d～-5d), anti-thymocyte globulin (ATG) 2.5mg/kg/d (-2d～-d).Graft-versus-host disease (GVHD) prophylaxis:cyclosporine (CsA) or tacrolimus (Tac), mycophenolate mofetil (MMF), a short-acting methotrexate (MTX).Results:Four patients were successfully transplanted hematopoietic reconstruction and long-term, stable donor implants, mean absolute neutrophil and platelet engraftment were: 12d and 17d. During the transplant occurred in 4 patients with varying degrees of acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD), which is common in skin aGVHD (Ⅰ° and Ⅱ°) and liver (Ⅰ°,Ⅱ° and Ⅳ°) and hemorrhagic cystitis (HC), cGVHD common in a wide range of skin and oral. In addition to cases of three patients considerations aGVHD (liver Ⅱ°) and Multiple organ failure to+ 96d death, the other after the administration of immunosuppressive therapy, all the better. Are currently alive and healthy.Conclusion:RIC-haplo-HSCT treatment of hematologic malignancies is safe, feasible and effective, RIC-haplo-HSCT donor stem cells make rapid implantation, successful recovery of hematopoietic function reconstruction, and no severe GVHD occurred in this study can be further expand the sample to provide a basis for clinical treatment.