Clinical Analysis Of Chemotherapy Combined With HLA-mismatched G-PBSC Infusion In The Treatment Of Malignant Hematopathy

Objective:To investigate the efficacy and clinical application of microtransplantation(chemotherapy combined with HLA-mismatched G-PBSC infusion)in the treatment of malignant hematopathy.Patients and Methods:A retrospective study was done about the clinical data of 13 patients who received microtransplantation from May 2015 to December 2016 at the our Hospital,Of the 13 patients,7were AML(5 cases remission,2 cases relapsed),3 were ALL(3 cases were remission),1 was MAL(relapsed),1wes MDS-1(remission),1 was Non-Hodgkin 's lymphoma ? group B(partial remission).According to the patient's condition,13 patients were treated with different pretreatment chemotherapy after chemotherapy,hematopoietic stem cells to micro-transplantation3 to 4 times,each infusion of hematopoietic stem cells MNC> 3.0 × 108 / Kg,hematopoietic stem cells CD3 + T> 1.0 × 108 / Kg.To observe the recovery time of platelet and neutrophils in patients with hematopoietic stem cell microtransplantation,the occurrence of acute and chronic graft versus host disease(GVHD)and other adverse reactions.Results:Among the 13 patients,8 were male(62%)and 5 were female(38%).Aged 9-75 years,the median age of 44 years old;of intermediate-risk group 8 patients,of high-risk group 5 patients.Of the 13 patients,11 were HLA-related donors(92%).2 cases of blood related HLA completely incompatible donor(8%).Thirty patients completed 25 cases hematopoietic stem cell microtransplatation,4 patients completed micro-transplantation of hematopoietic stem cells in 3times,3patientscompleted micro-transplantation of hematopoietic stem cells in 3 times,3 patients completed microtransplantation of hematopoietic stem cells in 2 times and 6 patients completed micro-transplantation of hematopoietic stem cells in 1 times;At the end of March 1,2017,Of the13 patients,5 died and 8 survived,of which 2 had relapsed.Among them,8 cases were in the risk group,6 cases survived,of which 1 case of recurrence,DFS was 62.5%;Among them,8 cases were in the intermediate-risk,6 cases survived,of which 1 case of recurrence,DFS was 62.5%;High risk group 5 cases,surviving 2 cases,of which 1 case of recurrence,DFS was 20%.4 casesof recurrence death in the death cases,1 death associated with transplantation.After themicrotransplantation of hematopoietic stem cells,the number of days of neutrophil recovery was 5 to 14 days,the average number of days of recovery was 8 days,the platelet recovery time was 6 to 20 days,and the average recovery time was 11 days.All patients had no acute and chronic GVHD during microtransplantation.Conclusion1.3 patients after repeated chemotherapy after recurrence of hematopoietic stem cells to micro-transplantation to achieve remission,hematopoietic stem cell micro-transplantation in the near future to be better to be further validated;2.This group of patients on the choice of all intermediate-and high-risk group,hematopoietic stem cell micro-transplantation in patients with poor efficacy,high recurrence rate;3.Hematopoietic stem cell micro-transplantation in the choice of donor unrestricted,platelet and neutrophils after transplantation to restore faster,and no acute and chronic GVHD occurred;4.The mechanism of micro-transplantation and efficacy is still in the exploratory stage,still need a large number of cases to verify the results.