The Analysis Of Curative Effect Of High-dose Haploidentical Peripheral Blood Stem Cell Transplantation With Reduced Intensity Conditiong Regimen In The Treatment Of Patients With AML/MDS>50 Years Old

Objective:To analyze the efficacy of reduced intensity conditioning(RIC)regimen for patients with acute myeloid leukemia/myelodysplastic syndrome over 50 years old for the treatment of high-dose haploidentical peripheral blood stem cell transplantation(RIC-haplo-HDPBSCT).Methods: A retrospective analysis clinical data of 23 patients with acute myeloid cells/myelodysplastic syndrome>50 years of age who underwent reduced intensity conditioning(RIC)regimen at the Hematology Research Center of the First Affiliated Hospital of Xinjiang Medical University from January 2014 to October2020.twenty patients received FAB+ATG regimen(fludarabine+cytarabine+busulfan+rabbit anti-human thymocyte immunoglobulin),three patients recieved CABA+ATG regimen(cladribine+cytarabine+busulfan+azacitabine+rabbit anti-human thymocyte immunoglobulin),all patients use cyclosporine A(Cs A)/tacrolimus(Tac)+ short-range methotrexate(MTX)+Snapdragon(MMF)+ glucocorticoid Hormone(GLU)+CD25 monoclonal antibody regimen is used to prevent graft-versus-host disease.All patients are infused with high-dose non-in vitro T-depleted peripheral blood stem cells.Results: thirty days after transplantation,22 patients achieved complete donor chimerism.One of them was mixed chimerism 15 days after transplantation and graft rejection occurred thirty days after transplantation.all 23 patients had hematopoietic reconstitution.The median implantation time of neutrophils was 18(12-29)days,and that of platelets was 21(11-36)days.The incidence of grade Ⅱ-Ⅳ and grade Ⅲ-Ⅳa GVHD was 28.6% and 9.5%,respectively.The incidence of c GVHD in one year was28.6%(All patients had localized chronic graft-versus-host disease).The OS of 3 years were 78.9% and 59.2% respectively.NRM was 13.6% in both years.The 3-year DFS was81% and 60.7% respectively.The 2-year recurrence rate was 26.5%.Conclusion:high-dose haploidentical peripheral blood stem cell transplantation following reduced intensity conditioning regimen is an effective method for AML / MDS patients aged over50 years.