Second hematopoietic stem cell transplantation with a new haploid-mismatched donor in relapsed patients after first transplantation: prognostic analysis of 11 cases

Panpan ZHU; Yibo WU; Lizhen LIU; Xiaoyu LAI; Jimin SHI; He HUANG; Yi LUO

doi:10.16016/j.1000-5404.202108091

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Second hematopoietic stem cell transplantation with a new haploid-mismatched donor in relapsed patients after first transplantation: prognostic analysis of 11 cases

Monographic Reports: Basic and clinical research on complications after hematopoietic stem cell transplantation | 更新时间：2026-01-09

- Second hematopoietic stem cell transplantation with a new haploid-mismatched donor in relapsed patients after first transplantation: prognostic analysis of 11 cases
- Journal of Third Military Medical University Vol. 43, Issue 21, Pages: 2294-2301(2021)
- 作者机构：
  
  310003 杭州，浙江大学医学院附属第一医院骨髓移植中心，浙江大学血液学研究所
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.202108091
  CLC： R617;R730.7;R733.7
- Received：13 August 2021，
  
  Revised：2021-09-17，
  
  Published：15 November 2021
- 稿件说明：
移动端阅览
Panpan ZHU, Yibo WU, Lizhen LIU, et al. Second hematopoietic stem cell transplantation with a new haploid-mismatched donor in relapsed patients after first transplantation: prognostic analysis of 11 cases[J]. Journal of Third Military Medical University, 2021, 43(21): 2294-2301.
DOI：

Panpan ZHU, Yibo WU, Lizhen LIU, et al. Second hematopoietic stem cell transplantation with a new haploid-mismatched donor in relapsed patients after first transplantation: prognostic analysis of 11 cases[J]. Journal of Third Military Medical University, 2021, 43(21): 2294-2301. DOI： 10.16016/j.1000-5404.202108091.

摘要

目的

探讨新单倍体不合供者作为二次移植替代供者的移植方案治疗血液系统恶性肿瘤异基因造血干细胞移植(allogenetic hematopoietic stem cell transplantation，allo-HSCT)后复发患者的临床预后。

方法

回顾性分析2013年10月至2021年6月在浙江大学医学院附属第一医院行新单倍体不合二次移植的11例血液系统恶性肿瘤患者的临床资料。患者均在原发病完全缓解(complete remission，CR)状态下行二次造血干细胞移植，其中6例患者在二次移植后接受供者淋巴细胞输注(donor lymphocyte infusion，DLI)。随访观察患者的临床预后，初步探索新单倍体不合二次移植的疗效。

结果

11例患者中位随访9.4(2.9~94.9)个月，3例患者半相合二次移植后因复发而死亡，1例因肺部感染而死亡，余7例均处于原发病缓解生存。二次移植后1年总体生存率(overall survival，OS)为77.9%(95%

: 54.6%~99.9%)，无白血病生存率(leukemia-free survival，LFS)为77.9%(95%

: 54.6%~99.9%)；半相合二次移植联合DLI的1年OS为83.3%(95%

: 58.3%~99.9%)。二次移植后患者的1年累积复发率为22.1%。

结论

新单倍体不合二次移植治疗allo-HSCT后复发患者可行；且不显著增加治疗相关的死亡，具有一定的安全性。

Abstract

Objective

To investigate the clinical outcome of the patients with hematologic malignancy recurrence following first allogenetic hematopoietic stem cell transplantation (allo-HSCT) and receiving second transplantation from an alternative haploid-mismatched donor.

Methods

We retrospectively reported the clinical data of 11 patients with hematologic malignancies who underwent a second HSCT using a new haploidentical related donor (HRD) in our center between October 2013 and June 2021. At the second transplantation

all patients were in complete remission (CR). Six of them received donor lymphocyte infusion (DLI) after the second transplantation. The clinical prognosis of the patients was followed up to primarily explore the effect of secondary transplantation.

Results

The median follow-up was 9.4 (2.9~94.9) months. Of the 11 relapsed patients

3 patients died of disease relapse and 1 patient died of lung infection

and the remaining 7 patients survived with CR. The 1-year overall survival (OS) rate was 77.9% (95%

: 54.6%~ 99.9%)

so was 1-year leukemia-free survival (LFS) rate. For the 6 patients receiving DLI

the 1-year OS rate was 83.3% (95%

: 58.3%~99.9%). The cumul

ative incidence of relapse was 22.1% in the 11 patients.

Conclusion

A second HSCT using a new haploid-mismatched donor is a feasible strategy for the patients with hematologic malignancy recurrence after the first transplantation. It has no significant increase in treatment-related death

and shows a certain safety.

关键词

Keywords

references

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