| Objective:To compare the antileukemic effect and safety of chemotherapy alone and chemotherapy followed by donor stem cell infusion (DSI) in patients with relapsed leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT); and also to investigate prognostic factors in this patients.Methods:During January2006to December2012,49patients who relapsed acute leukemia after allo-HSCT in our center were admitted in this study. Twenty patients received chemotherapy followed by DSI, remaining29patients received chemotherapy alone. The endpoint of follow-up for all of the surviving patients were December31,2013. We compared and analyzed the differences of survival between chemotherapy followed by DSI and chemotherapy alone, aiming to evaluate their prognosis after relapse of allo-HSCT with different treatment. We also explored safety in these treatment and investigated prognostic factors in all patients.Results:In patients receiving chemotherapy followed by DSI, complete remission rate was significantly higher (40.0%vs.13.8%, P=0.036), and1-year overall survival (OS) and disease-free survival (DFS) was significantly improved (OS:32.3%vs.10.3%, P=0.005; DFS:25.8%vs.6.9, P=0.005) compared with patients receiving chemotherapy alone. There was no significantly differences in treatment related mortality between two intervention group (34.0%vs.33.7%, P=0.712). Multivariate analysis demonstrated that patients with chronic graft-versus-host disease (cGVHD) after intervention (RR=0.425, P=0.043) was associated with a better prognosis. Furthermore, the1-year OS and DFS of the patients with cGVHD after intervention was41.9%and6.3%, which were significantly higher than the patients without cGVHD.Conclusion:The study suggest that chemotherapy followed by DSI with stronger antileukemic effect and better survival in relapsed acute leukemia after allo-HSCT. Furthermore, the study suggests that chronic GVHD after intervention are associated with a longer survival. |
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