Clinical Features And Treatment About Hemorrhagic Cystitis In Related HLA Haploidentical Non T Cell-depleted In Vitro Peripheral Blood Hematopoietic Stem Cell Tansplantation

Objective:To analyze the clinical features of hemorrhagic cystitis (HC), risk factors and treatment strategies about the related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation (RHNT-PSCT). Methods:Select the105patients who underwent the RHNT-PSCT we designed from January2004to December2012to analyze the clinical characteristics of HC morbidity, grading and treatment, and compared with that of the112patients who taked the HLA-matched sibling non T cell-depleted in vitro peripheral blood hematopoietic stem cell transplantation (MSNT-PSCT) simultaneously. Results:41cases in105patients who underwent our RHNT-PSCT(RH group) occurred HC.and180d cumulative incidence of HC was39.05%, it is significantly higher than that of the patients who taked MSNT-PSCT (MS group)(17.86%, P<0.05). In RH group,31cases occurred mild HC and the incidence was75.6%,10cases occurred severe HC and the incidence was24.6%, but the cumulative incidence of mild and severe HC had no significant difference between the two groups. The median time of onset HC and median duration in RH group is32(2-50) days and25(6to116) days respectively, therefore; there is no significant differences compare to MS group; verall effective rate of HC treatment group was100%with95.1%complete remission rate (CR rate); while the overall effective rate and CR rate are equal in MS group, which is100%. Between the two groups, mild and severe HC line treatment difference was no significant (P=0.063, P=0.623).First-line therapy was invalid for most severe HC, the effective rate of third-line hormonal therapy was100%for severe HC in RH groupe. Univariate analysis demonstrated three risk factors are highly related to incidence of HC, which are age≤25years of age, disease risk, HLA haplotype transplant conditioning regimen. Multivariate analysis found that HLA haplotypes transplantation is an independent risk factor for HC occurred. Conclusion:In our RHNT-PSCT, overall incidence of HC is significantly higher than it in MSNT-PSCT, while the severity, onset time and duration are similar, the overall effective rate of treatment is well, and the effect of stratified treatment is obvious. HLA haplotypes is independent risk factor for HC occurred.