[Multicenter report of nonmyeloablative allogeneic stem cell transplantation for hematologic diseases].

Abstract

OBJECTIVE:

To observe the treatment effect and toxicity of nonmyeloablative allogeneic stem cell transplantation (NST) for hematologic diseases.

METHODS:

A total of 243 hematologic diseases patients received HLA-identical NST were enrolled in this study from 9 transplant centers of NST Cooperative Group in China. Nonmyeloablative conditioning regimen was based on fludarabine (Flud), rabbit anti-human thymocyte globulin (ATG), cyclophosphamide (CTX) (FAC), and plus cytarabine or busulfan (BU) etc. Graft-versus-host disease (GVHD) prophylaxis included cyclosporin A (CsA) and mycophenolate mofetil (MMF).

RESULTS:

Among the 243 patients, 219 (90.1%) achieved full donor chimerism (FDC), 2(0.8%) engraftment failure. 78 (32.1%) had mixture chimerism (MC) at 4 weeks after NST, out of which 56 switched to FDC, 16 remained MC and 6 (2.5%) developed graft rejection. The incidence of acute GVHD was 34.2%, including 6.6% of grade III-IV acute GVHD. Chronic GVHD developed in 78 (32.1%) patients. The follow-up durations were 3 - 99 months, 162 (66.7%) were still alive and the overall survival rates were 76.5%, 73.9%, 70.7%, and 27.8% for MDS/SAA, chronic myeloid leukemia, acute leukemia at first remission, and refractory or relapsed leukemia, respectively.

CONCLUSIONS:

The nonmyeloablative allogeneic stem cell transplantation based on FAC conditioning results in sustained engraftment and mild aGVHD, providing a new feasible curative therapy for hematology diseases.

• Authors: Hui-sheng Ai, Xiao-jun Huang, Zhen-hua Qiao, Jian-min Wang, Bao-an Chen, Hai Bai, Bao-fu Shi, Ying-min Liang, Wan-jun Sun
• Journal: Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi (Zhonghua Xue Ye Xue Za Zhi) Vol. 30 Issue 8 Pg. 505-8 (Aug 2009) ISSN: 0253-2727 [Print] China
• PMID: 19954634 (Publication Type: English Abstract, Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Child
• China
• Female
• Graft vs Host Disease (prevention & control)
• Hematologic Diseases (surgery)
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Male
• Middle Aged
• Transplantation Conditioning (methods)
• Transplantation, Homologous
• Treatment Outcome
• Young Adult