二次移植治疗异基因造血干细胞移植后复发急性髓系白血病5例临床观察

蔺诗佳; 赵伟; 陈婷; 姚浛; 向茜茜; 饶军; 张诚; 刘耀; 高蕾; 高力; 张曦; 孔佩艳

doi:10.16016/j.1000-5404.201908017

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二次移植治疗异基因造血干细胞移植后复发急性髓系白血病5例临床观察

专题报道：造血干细胞移植与细胞治疗 | 更新时间：2026-01-09

- 二次移植治疗异基因造血干细胞移植后复发急性髓系白血病5例临床观察
- Second allogeneic hematopoietic stem cell transplantation in treatment of relapsed acute myeloid leukemia: clinical report of 5 cases
- 第三军医大学学报 2019年41卷第23期页码：2301-2306
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金青年科学基金(81600166)
- DOI：10.16016/j.1000-5404.201908017
  中图分类号：
- 收稿：2019-07-31，
  
  纸质出版：2019-12-25
- 稿件说明：
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蔺诗佳, 赵伟, 陈婷, 等. 二次移植治疗异基因造血干细胞移植后复发急性髓系白血病5例临床观察[J]. 第三军医大学学报, 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.
蔺诗佳, 赵伟, 陈婷, 等. 二次移植治疗异基因造血干细胞移植后复发急性髓系白血病5例临床观察[J]. 第三军医大学学报, 2019,41(23):2301-2306. DOI： 10.16016/j.1000-5404.201908017.

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.

摘要

Abstract

Objective

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

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

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

Allo-HSCT2 is an effective therapy for AML patients who relapsed after the first allo-HSCT.

关键词

Keywords

references

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