Analysis Of The Therapeutic Effect Of Relative HLA Haplo-HDPSCT In The Treatment Of Adult Ph~+ ALL

Objective:To retrospectively explore the clinical efficacy of relative HLA haplo-high dose peripheral stem cell transplantation(haploHDPSCT)as a transplantation mode in the treatment of adult philadelphia chromosome positive Ph+Acute Lymphocytic Leukemia(ALL).Materials and methods:From July 2011 to June 2022,the clinical efficacy of 25 adult Ph+ALL patients who received unique relative HLA haplo-HDPSCT at the Hematology Center of the First Affiliated Hospital of Xinjiang Medical University was analyzed,and monthly lumbar puncture and intrathecal injection were performed to prevent central nervous system leukemia.Before transplantation,23 cases were completely relieved after the first course of treatment(CR1),and 2 cases were completely relieved after the second course of treatment(CR2).Before transplantation,there were 9 positive patients with minimal residual disease(MRD+),including 8 cases of BCR-ABL1(p190),1 case of BCR-ABL1(p210),and 16 cases of negative patients with minimal residual disease(MRD-);the results of the myeloablative pretreatment protocol(MAC)showed 21 cases of ABU/CY+ATG,while results of the reduced dose pretreatment protocol(RIC)showed 4 cases of FAB+ATG.Results:The hematopoietic function of 25 patients was reconstructed after stem cell infusion;the median implantation time of neutrophils was 16(12-23)days after transplantation and the platelet implantation time was 14(11-33)days after transplantation.There were 15 patients with Acute GVHD(aGVHD),10 patients(40%)with Ⅱ-Ⅳdegree aGVHD,and 1 patient(4%)with Ⅲ-Ⅳ degree aGVHD;there were four relapses(16%)and four deaths(three non-relapsing death and one relapsing death).The DFS for 2 and 5 years was 77%,the OS for 2 and 5 years was 92%and 79%,respectively,and the NRM for 2 years was 4%.Conclusion:The unique transplantation mode of haplo-HDPSCT in this center has significant clinical efficacy in the treatment of Ph+ALL.