Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) For Hematologic Malignancies

Objective:To investigate the application ofallo-HSCT in the treatment of hematologic malignancies.Methods: Night patients with hematologic malignancies were treated by allogeneic peripheral blood stem cell transplantation (allo-PBSCT)and Two treated with PBSCT and bone marrow transplantation (BMT). The donors were HLA-identical siblings. Conditioning regimen was Busu1fan/Cyclophosphamide (BU/CY) or Busul fan/Melphalan/Mitoxantrone .A combination of cyclosporine and methotrexate was administered to prevent graft-versus-host disease(GVHD) .Results: all the patients were engrafted and hematopoietic reconstitution was rapid: neutrophils achieving 0.5×109/L on day 14.2(range, 12?0), platelets >20×109/L on day 16. 4 (range,11~23). Acute GVHD occurred in 5 patients(5/11, 45.5%) and chronic GVHD occurred in 3 patients(27.3%). All the eleven patients developed CMV infection or other infection.One patient developed Veno-occlusive disease (9. 1%). One case developed hemorrhagic cystitis(9.1%) . One patient developed CMV interstitial pneumonia(9.1%) . The mixed transplantations of BM and PBSC was applied in 2 patientswhose ABO blood type mismatched. No hemolytic reaction andpure-red aplastic anemia occurred. Drug-resistant relapse occurred in 1 patient with malignant lymphoma. HBV was taken along by receptor and donor. After allo-HSCT there was a complete remission. The median follow-up duration was 22.5(6~40) months. One patient died of cerebral hemorrhage 9 months after ALL transplantation. One patient was lost 13 months after ALL transplan tation. The rest 9 patients survive up to now. Transplant related death rate was zero.Conclusions: allo-HSCT is the most effective way for treating hematologic ma 1ignancies, especia 11y for the patients who have no complete remission to the routine chemotherapy drug-resistant. The mismatched blood type of ABO and donors of Hepatitis B are not the obstacle to transplantation.