Genetic Haploidentical Peripheral Blood Stem Cell Transplantation For Treatment Of Myelodysplastic Syndrome

BackgroundAllogeneic hematopoietic stem cell transplantation has been the only cure method for myelodysplastic syndrome.The best choice of donors is human leukocyte antigens(HLA)-identical related.Due to the reason of the family planning policy in the past,it has been difficult to looking for human leukocyte antigen matched sibling donors(HLA-MSD).It is also difficult to looking for human leukocyte antigen matched unrelated donors(HLA-MUD)in the China Marrow Donor Program(CMDP)and there is the disadvantage of waiting for the time to donate and those donors are usually easy to regret to donate.Therefore.HLA-identical transplantation is relatively reduced.In recent years,haploid allogeneic hematopoietic stem cell transplantation(haplo-HSCT)has been gradually improved,and genetic haploidentical peripheral blood stem cell transplantation has become an important treatment choice for malignant hematopoietic disease.ObjectivesTo analyse and evaluate the clinical effect of genetic haploidentical peripheral blood stem cell transplantation in patients with myelodysplastic syndrome.Methods1.we analyzed of 25 patients who accept genetic haploidentical peripheral blood stem cell transplantation from 2011.1 to 2018.32.The conditioning regimen of haploidentical peripheral blood stem cell transp-lantation is “modified Busulfan(BU)+ Cyclophosphamide(Cy/CTX)+ Antithymocyte globulin(ATG)”;The prevention of graft-versus-host disease(GVHD)adopted applying “cyclosporine A(CsA)+ mycophenolate mofetil(MMF)+ Short-range methotrexate(MTX)±Basiliximab”.3.Statistical analysis: SPSS 22.0 software was used for statistical description of case information and related therapeutic data,and kaplan-meier method was used to estimate survival rate and depict survival curves.Results1.The median follow-up time of 25 patients is 221 days(22d-1403d),infection rate of Granulocyte lack period 72.0%(18/25);the rate of neutrophil implantation is 100%(25/25),the median implanted the time is 13d(7d-17d);the rate of platelet engraftment is 84.0 %(21/25),the median implanted the time is 15d(7d-68d).2.The incidence of hemorrhagic cystitis of 25 patients is 32.0%(8/25);The incidence of GVHD is 56.0%(14/25),including acute GVHD 32.0%(8/25)and chronic GVHD 24.0%(6/25).3.By Kaplan-Meier method,the2-year Ovreall survival(OS)of 25 patients is 49.9%,disease-free survival(DFS)is 49.6%;the accumulated relapse rate(RR)is 12.0%(3/25),and non-relapse mortality(NRM)and thransplant-related mortality(TRM)rates is both 40.0%(10/25).ConclusionsFor myelodysplastic syndrome patients need allo-HSCT,in the absence of HLA-MSD and HLA-MUD,genetic haploidentical donors can be as an important alternative donor source,genetic haploidentical peripheral blood stem cell transplantation is the effective treatment option.