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IR@PKUHSC  > 北京大学第二临床医学院  > 血液科  > 期刊论文
学科主题: 临床医学
题名:
HLA-mismatched/haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for chronic myeloid leukemia: Improved outcomes in patients in accelerated phase and blast crisis phase
作者: Huang Xiao-Jun; Xu Lan-Ping; Liu Kai-Yan; Liu Dai-Hong; Chen Huan; Han Wei; Chen Yu-Hong; Wang Jing-Zhi; Chen Yao; Zhang Xiao-Hui; Shi Hong-Xia; Lu Dao-Pei
关键词: blood and marrow transplantation ; chronic myeloid leukemia ; HLA-mismatched
刊名: ANNALS OF MEDICINE
发表日期: 2008
DOI: 10.1080/07853890801908903
卷: 40, 期:6, 页:444-455
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: MATCHED UNRELATED DONORS ; VERSUS-HOST-DISEASE ; MARROW TRANSPLANTATION ; IMATINIB ; BLOOD ; GRAFT ; MALIGNANCIES ; RECIPIENTS ; SURVIVAL ; RELAPSE
英文摘要:

Background. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only proven curative therapy for chronic myeloid leukemia (CML), but lack of human leukocyte antigen (HLA)-matched sibling or unrelated donors has restricted its application. Recently, we developed an effective method for haploidentical allo-HSCT achieving comparable outcomes to HLA-identical transplantation.

Aim. To evaluate the outcomes of CML patients who underwent haploidentical allo-HSCT.

Methods. Ninety-three patients were treated with a modified busulfan (BU)/cyclophosphamide (CY)2 regimen, including antithymocyte globulin followed by unmanipulated blood and marrow transplantation.

Results. Our data showed that the cumulative incidence of acute graft-versus-host disease (GVHD) was 64.52%, and grade III-IV was 26.45%, 61.79% had chronic GVHD, and 28.93% had extensive chronic GVHD. Non-relapse mortality varied at 8.72% (100 days), 20.72% (1 year) and 20.72% (2 years). Probability of 1-year and 4-year leukemia-free survival was similar in chronic phase (CP) 1, CP2/CR2, accelerated phase, and blast crisis patients. Probability of 4-year overall survival varied as 76.5% (CP1), 85.7% (CP2/CR2), 73.3% (accelerated phase), and 61.5% (blast crisis). Multivariate analysis indicated that factors affecting transplantation outcomes were HLA-B+DR mismatches versus others for II-III acute GVHD and III-IV acute GVHD, the stage of disease at transplantation for relapse, and the time from diagnosis to transplantation for leukemia-free survival, overall survival, and transplantation-related mortality. In our protocol, survival of HSCT for advanced CML was similar to stable stage.

Conclusions. For patients lacking an HLA-identical related donor, haploidentical relatives are alternative HSCT donors.

语种: 英语
所属项目编号: NECT-04-0011 ; 2006-1010 ; 2006AA02Z4A0 ; IRT0702
项目资助者: New Century Excellent Talents in University ; Scientific Research Fund for Capital Medicine Development ; HI-tech research development program of China ; Program for Innovative Research Team in University
WOS记录号: WOS:000258805200005
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/56980
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: Peking Univ, Inst Hematol, Peoples Hosp, Beijing 100044, Peoples R China

Recommended Citation:
Huang Xiao-Jun,Xu Lan-Ping,Liu Kai-Yan,et al. HLA-mismatched/haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for chronic myeloid leukemia: Improved outcomes in patients in accelerated phase and blast crisis phase[J]. ANNALS OF MEDICINE,2008,40(6):444-455.
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