Received:31 July 2019,
Published:25 December 2019
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Shijia LIN, Wei ZHAO, Ting CHEN, et al. Second allogeneic hematopoietic stem cell transplantation in treatment of relapsed acute myeloid leukemia: clinical report of 5 cases[J]. Journal of Third Military Medical University, 2019, 41(23): 2301-2306.
Shijia LIN, Wei ZHAO, Ting CHEN, et al. Second allogeneic hematopoietic stem cell transplantation in treatment of relapsed acute myeloid leukemia: clinical report of 5 cases[J]. Journal of Third Military Medical University, 2019, 41(23): 2301-2306. DOI: 10.16016/j.1000-5404.201908017.
Objective
2
To investigate the clinical efficacy and its influencing factors of second allogeneic hematopoietic stem cell transplantation (allo-HSCT2) in acute myeloid leukemia (AML) patients who have relapsed after the first allogeneic transplantation.
Methods
2
Clinical data of 5 patients with refractory/relapsed AML who had relapsed after allo-HSCT in our medical center from January 2012 to October 2018 were collected in this study. After re-induction (CR2-MRD
-
was achieved in 3 cases
CR2-MRD
+
in 1 case
and NR in 1 case) and myeloablative pretreatment
allo-HSCT2 was conducted to all of them. The clinical process and outcome of these cases were analyzed
and the possible eff
ects of alleviation status
donor selection
pretreatment protocol of the allo-HSCT2 patients before transplantation on the complications
recurrence and death (RM)
transplant-related mortality (TRM)
and transplantation outcome were also investigated.
Results
2
Until the 5 patients were followed up to June 30
2019
all of them achieved complete donor implantation. Three of them had no relapse within 17 months
and 1 patient developed acute graft versus host disease (aGVHD) grade Ⅰ and chronic graft versus host disease (cGVHD) as severe lung disease
and hence deceased due to respiratory failure in 20 months after the allo-HSCT2. No serious HSCT-related complications were observed in the other 4 patients. The patients with complete remission of allo-HSCT2 with a negative status of (minimal residual disease
MRD)
proved to have a better prognosis. Second allo-HSCT did not increase TRM compared with one-time allo-HSCT. For the patients receiving allo-HSCT2
the GVL effect of haploid transplantation had no significant advantage against full-matched HSCT.
Conclusion
2
Allo-HSCT2 is an effective therapy for AML patients who relapsed after the first allo-HSCT.
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