[Therapeutic efficacy of second allo-HSCT for aplastic anemia after failure of first allo-HSCT].

Abstract

This study was purposed to evaluate the curative efficacy of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) after failure of the first allo-HSCT in aplastic anemia patients, the cause of implant failure after allo-HSCT and clinical data of 10 severe aplastic anemia (SAA) patients in the second allo-HSCT were retrospectively analyszed. The second HSCT conditioning programs include: cyclophosphamide (CTX) + fludarabine (FLU)+ anti-thymocyte globulin (ATG) combination chemotherapy for 3 cases; CTX + FLU + white busulfan (Bu) + ATG combination chemotherapy for 7 cases. The prevention regimen of graft-versus-host disease (GVHD) include cyclosporine (CsA), mycophenolate mofetil (MMF) and methotrexate (MTX). The median count of mononuclear cell infusion was 12.17 (5.99-18.12)×10(8)/kg. The CD34(+) cell count was 5.2 (3.8-10.9)×10(6)/kg. The results showed that 10 evaluable patients achieved hematopoietic reconstitution with absolute neutrophil >0.5×10(9)/L, platelets >20×10(9)/L at 15d (8-21d) and 17d (11-27d) after transplantation. The grade I aGVHD occurred in 2 case, grade II in 1 case, chronic GVHD in 3 cases. Transplant-related deaths occurred in 4 cases. The disease-free survival rate, transplant-related mortality, GVHD after transplantation were 60%, 40% and 50% respectively. It is concluded that the second allo-HSCT is an effective therapy for aplastic anemia after allo-HSCT implant failure.

• Authors: Feng Zhu, Hui-Ren Chen, Zhi Guo, Xiao-Dong Liu, Xue-Peng He, Jing-Xing Lou, Kai Yang, Yuan Zhang, Peng Chen
• Journal: Zhongguo shi yan xue ye xue za zhi (Zhongguo Shi Yan Xue Ye Xue Za Zhi) Vol. 22 Issue 5 Pg. 1348-53 (Oct 2014) ISSN: 1009-2137 [Print] China
• PMID: 25338587 (Publication Type: Journal Article)

Chemical References

• Antilymphocyte Serum
• Cyclosporine
• Mycophenolic Acid
• Methotrexate

Topics

• Allografts
• Anemia, Aplastic (therapy)
• Antilymphocyte Serum
• Cyclosporine
• Disease-Free Survival
• Graft vs Host Disease
• Hematopoietic Stem Cell Transplantation
• Humans
• Methotrexate
• Mycophenolic Acid (analogs & derivatives)
• Retrospective Studies