The Clinical Analysis Of Allogeneic Hematopoietic Stem Cell Transplantation Treatment In 32 Patients With Acute Lymphoblastic Leukemia

Objective To study the effect of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in treatment of patients with acute lymphoblastic leukemia(ALL).Methods A total of 32 patients,including 8 cases with Philadelphia chromosome(Ph)-positive ALL and 24 cases with Ph-negative ALL,were treated with allo-HSCT in our hospital from March 2009 to December 2016.All cases included 26 cases in CR1,3 cases in CR2,2 cases in PR and 1 cases in UR before allo-HSCT treatment.9 cases were HLA-identical sibling,5 cases were HLA-matched unrelated volunteer and 18 cases were haploidentical sibling.2 patients underwent bone marrow transplantation(BMT)and peripheral blood stem cell transplantation(PBSCT).Conditioning regimen: 23 cases received busulfan/cyclophosphamide(Bu/Cy),8 cases received total body irradiation(TBI)/Cy and 1 case received Flu/Bu.Cyclosporine A(Cs A),mycophenolate mofetil(MMF),antithymocyte globulin(ATG)and methotrexate(MTX)were used to prevent acute graft versus host disease(a GVHD).Results All patients achieved hematopoietic reconstitution after allo-HSCT.With the average follow-up of 18.5 months,there were 21 cases with disease-free survival(DFS)for 2 to 55 months after allo-HSCT treatment.Overall survival rate was 65.6%.The mortality was 34.4%(11/32)owing to a GVHD,disseminated infection,transplant associated thrombotic microangiopathy(TA-TMA),relapse and other complications.Conclusion Allo-HSCT is an effective way for the treatment of ALL,and methods that could reduce the relapse and severe complications after allo-HSCT need further research.