Yuanyuan Shi, Yi He, Gui-xin Zhang, W. Zhai, Qiao-ling Ma, A. Pang, Donglin Yang, Rong-li Zhang, Jialin Wei, E. Jiang, M. Han
{"title":"Allogeneic hematopoietic stem cell transplantation for chronic myelomonocytic leukemia","authors":"Yuanyuan Shi, Yi He, Gui-xin Zhang, W. Zhai, Qiao-ling Ma, A. Pang, Donglin Yang, Rong-li Zhang, Jialin Wei, E. Jiang, M. Han","doi":"10.3760/CMA.J.ISSN.0254-1785.2019.06.005","DOIUrl":null,"url":null,"abstract":"Objective \nTo explore the therapeutic efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in chronic myelomonocytic leukemia (CMML) patients. \n \n \nMethods \nThe clinical data were retrospectively analyzed for 19 CMML patients undergoing allo-HSCT. Engraftment, graft versus host disease (GVHD), infection, relapse, splenomegaly and survival were observed. And the clinical outcomes of allo-HSCT for CMML were analyzed. \n \n \nResults \nHematopoiesis reconstitution was not attained in 2 recipients due to early death post-transplantation. Neutrophil engraftment was obtained in 17 recipients with a median time of 14(11-18) days. Neutrophil engraftment and platelet engraftment were achieved in 15 recipients with a median time of platelet engraftment at 15 (12~70) days. Seven patients developed acute GVHD (grade 1, n=5; grade 2~4, n=3) while another 8 patients had chronic GVHD (extensive, n=5). Ten patients (52.6 %)had palpable splenomegaly (SPM) before allo-HSCT, 8 patients were diagnosed ultrasonically after transplantation, all 4 patients without a significant reduction of spleen died while all 4 patients with a significant reduction of spleen survived. After a median follow-up period of 31 (6-68) months, 3-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were (58.2±12.5)%, (36.3±14)%, (39.9±19)% and (37±12.6)% respectively. \n \n \nConclusions \nAs an effective therapy for CMML, allo-HSCT may improve the survival of CMML patients. Palpable SPM pre-transplantation and no significant reduction post-transplantation are probably poor prognostic factor. \n \n \nKey words: \nAllogeneic hematopoietic stem cell transplantation; Leukemia; Splenomegaly","PeriodicalId":9885,"journal":{"name":"Chineae Journal of Organ Transplantation","volume":"29 1","pages":"339-344"},"PeriodicalIF":0.0000,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chineae Journal of Organ Transplantation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.0254-1785.2019.06.005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To explore the therapeutic efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in chronic myelomonocytic leukemia (CMML) patients.
Methods
The clinical data were retrospectively analyzed for 19 CMML patients undergoing allo-HSCT. Engraftment, graft versus host disease (GVHD), infection, relapse, splenomegaly and survival were observed. And the clinical outcomes of allo-HSCT for CMML were analyzed.
Results
Hematopoiesis reconstitution was not attained in 2 recipients due to early death post-transplantation. Neutrophil engraftment was obtained in 17 recipients with a median time of 14(11-18) days. Neutrophil engraftment and platelet engraftment were achieved in 15 recipients with a median time of platelet engraftment at 15 (12~70) days. Seven patients developed acute GVHD (grade 1, n=5; grade 2~4, n=3) while another 8 patients had chronic GVHD (extensive, n=5). Ten patients (52.6 %)had palpable splenomegaly (SPM) before allo-HSCT, 8 patients were diagnosed ultrasonically after transplantation, all 4 patients without a significant reduction of spleen died while all 4 patients with a significant reduction of spleen survived. After a median follow-up period of 31 (6-68) months, 3-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were (58.2±12.5)%, (36.3±14)%, (39.9±19)% and (37±12.6)% respectively.
Conclusions
As an effective therapy for CMML, allo-HSCT may improve the survival of CMML patients. Palpable SPM pre-transplantation and no significant reduction post-transplantation are probably poor prognostic factor.
Key words:
Allogeneic hematopoietic stem cell transplantation; Leukemia; Splenomegaly