406 Haploidentical Allogeneic Hematopoietic Stem Cell Transplantation for the Treatment of Refractory/Relapsed Acute Leukemia

Track: Contributed Abstracts
Saturday, February 16, 2013, 6:45 PM-7:45 PM
Hall 1 (Salt Palace Convention Center)
Yu Wang, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Dai-hong Liu, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Kai-yan Liu, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Lan-ping Xu, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Xiao-hui Zhang, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Wei Han, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Huan Chen, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Yu-hong Chen, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Feng-rong Wang, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Jing-zhi Wang, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Hai-xia Fu, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Xiao-jun Huang, MD , Institute of Hematology, Peking University People's Hospital, Beijing, China
Objective:To retrospectively analyze the results of refractory/relapsed acute leukemia patients who received human leukocyte antigen (HLA)-mismatched/haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to perform risk factor analysis.

Methods: Of the 96 refractory/relapsed acute leukemia(AL) patients, 56 patients suffered from acute myeloid leukemia(AML) and 35 patients suffered from acute lymphoid leukemia (ALL), all in non-remission(NR) or relapse before transplant. Most patients received conditioning therapy comprised of modified busulfan/cyclophosphamide (BuCy) plus thymoglobulin (ATG).

Results:With a median follow-up of 373d(34-3157d), 33/96(34%) survived, 31/96(32%) survived without leukemia, 35/96(36%) relapsed. The estimated 3-year overall survival (OS) and disease-free survival (DFS) of the 96 cases was 30.2% and 29.0%. The 3-year OS were significantly higher for AML patients (39.2%) than for ALL patients (15.4%) (P=0.005), the OS probability of patients with prophylactic donor lymphocyte infusion (DLI) was superior to that of patients without prophylactic DLI (38.0% vs 11.8%,P=0.001). Sex, age, conditioning regimen (dosage of ATG), number of HLA mismatched or the number of stem cells infused were not the factors affecting OS, DFS and relapse. Multivariate analysis showed that the significant factors associated with higher OS were the use of prophylactic DLI,the disease type of AML and occurrence of chronic GVHD.

Conclusions:Haploidentical allo-HSCT can cure a significant proportion of refractory/relapsed acute leukemia patients. Prophylactic DLI can reduce relapse and increase survival; for patients with refractory/relapsed ALL, other post-transplant therapy should be explored.

See more of: Poster Session 2: Allogeneic Transplants
See more of: Contributed Abstracts
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