[Transplantations of allogenic and autologous hemopoietic stem cells in acute leukemia (results of 20-year experience)].
OBJECTIVE
To analyse results of transplantation of allogenic and autologous hemopoietic stem cells (allo-THSC and auto-THSC) with myeloablation preconditioning in patients with acute leukemia (AL) performed in 1987-2006.


METHODS
A total of 71 allogenic and 45 autologous THSC were performed in 116 patients with different AL variants. Conditioning in all allo-THSC included busulfan (16 mg/kg) and cyclophosphamide (120 mg/kg). This regimen was used in 29 recipients of auto-HSC. Cyclophosphamide in a dose 120 mg/kg and total radiation of the body in a dose 12 Gy were given to 16 recipients. Overall, relapse-free and event-free survival of patients after THSC were analysed as well as early (first 100 days) and overall lethality. Auto-THSC in 15 patients was for the first time followed by immunomodulating therapy aimed at prevention of AL relapses: in acute myeloid leukemia ATRA in combination with alpha-interferon, in acute lymphoblastic leukemia (ALL)--ronkoleukin, interleukin-2 preparation.


RESULTS
Overall survival of AL patients after allo-THSC for the observation period increased from 31 to 58%, early lethality fell from 44 to 4%. Results of allo-THSC conducted in the first complete remission were much better than in patients with other AL stages at the time of THSC. After auto-THSC 5-year survival rose from 22 to 60% while early lethality reduced from 33 to 4%. Administration of immunomodulating therapy after auto-THSC increases 5-year survival from 35 to 80%.


CONCLUSIONS
Outcomes of THSC in AL has improved for the last 20 years. Outcomes of allo-THSC performed in the first complete remission are much higher. Immunomodulating therapy after auto-THSC promoted better results.
Savchenko
V G
VG
Liubimova
L S
LS
Parovichnikova
E N
EN
Mendeleeva
L P
LP
Mamotiuk
K S
KS
Demidova
I A
IA
Gribanova
E O
EO
Gal'tseva
I V
IV
Pokrovskaia
O S
OS
Kuz'mina
L A
LA
Zhelnova
E I
EI
Kliasova
G A
GA
Glasko
E N
EN
Kaplanskaia
I B
IB
Poreshina
L P
LP
Kut'ina
R M
RM
Shpakova
A P
AP
Shtareva
E M
EM
Varlamova
S V
SV
Kalinin
N N
NN
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007167:Immunotherapy; D007951:Leukemia, Myeloid / Q000401:mortality* / Q000601:surgery* / Q000628:therapy; D008297:Male; D016019:Survival Analysis; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome