Clinical Outcome And Prognosis In Acute Myeloid Leukemia Patients Treated With Related HLA Haploidentical Non T Cell-depleted In Vitro Peripheral Blood Hematopoietic Stem Cell Tansplantation

Objective:To evaluate the outcome of acute myeloid leukemia(AML) patients treated with related HLA haploidentical non T cell-depleted in vitro peripheral blood hematopoi etic stem cell tansplantation(RHNT-PSCT) and analyse the prognostic factors.Methods:Retrospective analysis clinical data of the 120 AML patients who underwent related non T cell-depleted in vitro peripheral blood hematopoietic stem cell tansplantation designed from January 2004 to June 2015 in our centre,including 69 patients with HLA-haploiden tieal(RH group) and 51 patients with HLA-matehed(RM group).To compare the implanta tion rate,overal survival(OS),leukemia-free survival(LFS),relapse rate(RR),the incidence of aGVHD,the cumulative incidence of cGVHD and transplant-related mortality(TRM)between RH and RM groups.Then all patients evaluated for the prognostic factors we an alyzed.Results:2 in 69 cases of recipients underwent engraftment failure in RH,51 cases of recipients acquired engraftment in RM group.The median number of days of granuloc yte count exceeding 0.5×109/L and platelet count exceeding 20×109/L in RH group an d RM group was 14 d vs 13d(P=0.83)and 16 d vs 16d(P=0.76).In RH group,39 cases developed aGVHD(56.5%),while 34 cases developed cGVHD(cumulative incidence for3 years was 58%);In RM group,17 cases developed aGVHD(33.3%),while 29 cases dev eloped cGVHD(cumulative incidence for 3 years was 72%).The incidence of aGVHD in RH group was significantly higher than in RM group(P=0.012).There was no significant difference in incidenee of cGVHD(P=0.257).In RH group,11 cases had recurrence,the 3-year prohabilities of OS,LFS,TRM,RR were 70.1%,64.1%,18.3%,16.2%.In RM group,13 cases had recurrence,the 5-year prohabilities of OS,LFS,TRM,RR were 71.9%,64.9%,12.1%,26.2%.There was no significant difference in OS,LFS,RR,TRM between two groups(P>0.05).Univarite analysis demonstraced that the disease status before transplantation is related with outcome(P=0.01),and white blood cell count at initial diagnosis has some inf luence on the outcome(P=0.073).Multivariate analysis indicated that the disease status be fore transplantation and white blood cell count at initial diagnosis are the most important prognostic factors.Conclusion:The RHNT-PSCT protocol is feasible and safe for AML p atients,the disease status before transplantation and white blood cell count at initial diagn osis are the most important prognostic factors.