[Effects of combined therapy of human leucocyte antigen haploidentical related bone marrow transplantation and Chinese medicine in treating leukaemia].
OBJECTIVE
To explore the feasibility of human leucocyte antigen (HLA) haploidentical related T-cell undepleted allogeneic bone marrow transplantation (Allo-BMT) combined with Chinese medicine for the treatment of leukaemia.


METHODS
Four patients with chronic myeloblastic leukemia (CML) and 4 with acute myeloid leukemia (AML) received allo-BMT with graft from 1 - 3 HLA-mismatched related donors. All patients were pre-treated with standardized conditioning regimen consisting of high dose Ara-c, cyclophosphamide (CY) and total body irradiation (TBI) or busulfan. Donors were given G-CSF 250 microg/d for 7 days prior to marrow harvest. To prevent GVHD, besides application of CSA and MTX, ATG 2.5 mg/kg was given everyday for 4 days before transplantation, and MMF 1.0 g per day starting from the 7th day after transplantation. Chinese medicine for replenishing qi and yin and strengthening Pi and Wei was administrated orally after transplantation.


RESULTS
Successful haematopoietic reconstruction was seen in all patients. The median days for reaching of granulocyte >0.5 X 10(9)/L and platelet > 20 x 10(9)/L were 12 (range 10-14) and 20 (range 18-25) days respectively. GVHD of skin in various grade was seen in 7 patients, among whom only one advanced to grade IV; besides, 2 accompanied with GVHD of gut, one with hemorrhagic cystitis, one died for concurrent infection on the 81st day, and one left hospital of his own accord on the 46th day. The median follow-up duration was 18 (range 2-32) months, during this period six patients were alive in a disease-free situation.


CONCLUSIONS
Combined therapy of HLA haploidentical related T-cell undepleted Allo-BMT and Chinese medicine plus immunosuppressants with pre-harvest G-CSF application in doner could effectively reduce the incidence of acute severe GVHD and raise the disease-free survival rate in treating leukaemia.
Yu
Rong-xi
RX
Zhejiang Provincial Hospital of Traditional Medicine, Hangzhou 310006.
Zhou
Yu-hong
YH
Lin
Sheng-yun
SY
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D006239:Haplotypes; D006650:Histocompatibility Testing; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy
D004365:Drugs, Chinese Herbal; D006680:HLA Antigens