[Human leukocyte antigen mismatched hemopietic stem cell transplants for the treatment of leukemia].
OBJECTIVE
To explore the feasibility of HLA mismatched hemopietic stem cell transplants for the treatment of leukemia.


METHODS
Between July 2000 and December 2001, seven patients received hemopietic stem cell transplants(HSCT) with HLA mismatched family donors, including 3 chronic myelocytic leukemia (CML), 3 acute nonlymphocytic leukemia (ANLL), and 1 acute lymphocytic leukemia (ALL). Stem cell sources were bone marrow(n = 1) or G-CSF mobilized peripheral blood (n = 6). All the patients were conditioned with busulfan (BU) 12 mg.kg-1 and cyclophosphamide (CY) 3.6 g.m-2, of whom 4 were conditioned with additioned antithymocyte globulin(ATG). Graft versus host disease (GVHD) prophylaxis regimen consisted of cyclosporin-A (CSA), methotrexate (MTX) and mycophenolate mofetil(MMF).


RESULTS
One patients received 3.41 x 10(8) kg-1 mononuclear cells(MNC) from bone marrow; six patients received a mean number of 8.46 x 10(8) kg-1 (4.3 x 10(8)-15.4 x 10(8) kg-1) MNC from peripheral blood. The mean time of ANC > 0.5 x 10(9) L-1 was day 13 (11-16), and BPC > 20.0 x 10(9) L-1 was day 16 (11-23). All the patients got engraftment successfully and attained CR. Acute I-II GVHD occurred in 3(42.9%) patients, no acute III-IV GVHD occurred and extensive chronic GVHD did in 2(28.6%) patients. All the patients were alive and well after 6-24 months' follow-up.


CONCLUSIONS
(1) BU/CY plus ATG appears to be an effective conditioning regimen for HLA mismatched allogenic stem cell transplants. (2) G-CSF mobilized peripheral blood stem cells may be the source of stem cells even for HLA mismatched hemopietic stem cell transplants.
Huang
Xiaojun
X
Institute of Hematology, Peking University People's Hospital, Beijing 100044, China.
Chen
Yuhong
Y
Han
Wei
W
Chen
Yao
Y
Hong
Hong
H
Lu
Daopei
D
D016026:Bone Marrow Transplantation; D003520:Cyclophosphamide; D016572:Cyclosporine; D006086:Graft vs Host Disease; D016179:Granulocyte Colony-Stimulating Factor; D006680:HLA Antigens; D000949:Histocompatibility Antigens Class II; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008727:Methotrexate; D009173:Mycophenolic Acid / Q000031:analogs & derivatives; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D033581:Stem Cell Transplantation; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
D006680:HLA Antigens; D000949:Histocompatibility Antigens Class II; D016179:Granulocyte Colony-Stimulating Factor; D016572:Cyclosporine; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D008727:Methotrexate